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Maternal and Child Health Journal

, Volume 18, Issue 4, pp 858–863 | Cite as

Prevention of Recurrent Preterm Birth: Role of the Neonatal Follow-up Program

  • Erin A. S. ClarkEmail author
  • Sean Esplin
  • Leah Torres
  • David Turok
  • Bradley A. Yoder
  • Michael W. Varner
  • Sarah Winter
Article

Abstract

Preterm birth (PTB) is a public health crisis in need of effective preventative strategies. Multi-disciplinary Neonatal Follow-up Programs (NFPs) provide health services to preterm infants at high risk for developmental problems after discharge from US newborn intensive care units. We aimed to determine whether NFPs are a potentially effective venue for specialized maternal counseling and intervention aimed at reducing the high rate of recurrent PTB in this population. This prospective case series enrolled women with preterm children evaluated in the Utah Department of Health NFP, 2010–2012. Women were interviewed, received Maternal Fetal Medicine (MFM) counseling services, and maternal and neonatal records were abstracted. We assessed maternal demographics, medical history, and characteristics of the index pregnancy. We calculated the proportion of women with knowledge of PTB recurrence risk and available prevention strategies, and assessed current contraceptive use and reproductive plans. Ninety-six women with a history of early PTB (≤26 weeks and/or birth weight < 1,250 g) were evaluated. Nearly 1 in 5 women (19.8 %) evaluated reported sexual activity, desire to avoid pregnancy, and no current contraceptive use, and were therefore at imminent risk of unintended pregnancy. Of women without permanent contraception, only 24.3 % were aware of their individual PTB recurrence risk. Of women with a history of spontaneous PTB, only 4 % were aware of effective pharmacologic preventative strategies. Introduction of MFM consultation as part NFP multi-disciplinary services is a novel approach with the potential to reduce recurrent PTB in an exceptionally high-risk population.

Keywords

Department of Health Maternal Fetal Medicine Neonatal follow-up program Preterm birth Public health 

Notes

Acknowledgments

The authors thank Trece Swanson, DNP, CNM, for assistance with subject interviews and data collection (supported by the University of Utah Department of Obstetrics and Gynecology, Salt Lake City, Utah). They also thank the administration and staff of the Utah Department of Health Neonatal Follow-up Program in Salt Lake City, UT, for their support and facilitation of this Project.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erin A. S. Clark
    • 1
    Email author
  • Sean Esplin
    • 1
    • 2
  • Leah Torres
    • 1
  • David Turok
    • 1
  • Bradley A. Yoder
    • 3
  • Michael W. Varner
    • 1
  • Sarah Winter
    • 3
    • 4
  1. 1.Department of Obstetrics and GynecologyUniversity of Utah School of MedicineSalt Lake CityUSA
  2. 2.Intermountain HealthcareSalt Lake CityUSA
  3. 3.Department of PediatricsUniversity of Utah School of MedicineSalt Lake CityUSA
  4. 4.Utah State Department of HealthSalt Lake CityUSA

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