Pregnancy outcomes in a recurrent preterm birth prevention clinic

Am J Obstet Gynecol. 2011 Apr;204(4):320.e1-6. doi: 10.1016/j.ajog.2011.01.011. Epub 2011 Feb 23.

Abstract

Objective: We sought to compare rates of recurrent spontaneous preterm birth (PTB) and neonatal morbidity between women enrolled in a recurrent PTB prevention clinic compared to those receiving usual care.

Study design: This was a retrospective cohort study of women with a single, nonanomalous fetus and ≥1 spontaneous PTB <35 weeks. Women enrolled in a recurrent PTB prevention clinic were compared to those receiving usual care. The recurrent PTB prevention clinic was consultative and included 3 standardized visits. Usual-care patients were treated by their primary provider. The primary outcome was recurrent spontaneous PTB <37 weeks.

Results: Seventy recurrent PTB prevention clinic and 153 usual-care patients were included. Both groups had similar pregnancy histories. Recurrent PTB prevention clinic patients had increased utilization of resources, had lower rates of recurrent spontaneous PTB (48.6% vs 63.4%, P = .04), delivered later (mean 36.1 vs 34.9 weeks, P = .02), and had lower rates of composite major neonatal morbidity (5.7% vs 16.3%, P = .03).

Conclusion: Women referred to a consultative recurrent PTB prevention clinic had reduced rates of recurrent spontaneous prematurity and major neonatal morbidity.

Publication types

  • Comparative Study

MeSH terms

  • 17-alpha-Hydroxyprogesterone / therapeutic use
  • Adult
  • Cervical Length Measurement
  • Clinical Protocols
  • Cohort Studies
  • Female
  • Gynecological Examination
  • Humans
  • Male
  • Nifedipine / therapeutic use
  • Outpatient Clinics, Hospital*
  • Pregnancy
  • Pregnancy Outcome*
  • Premature Birth / prevention & control*
  • Retrospective Studies
  • Secondary Prevention
  • Tocolytic Agents / therapeutic use
  • Urinalysis
  • Utah

Substances

  • Tocolytic Agents
  • 17-alpha-Hydroxyprogesterone
  • Nifedipine