THE EFFECTIVENESS OF PRETERM-BIRTH PREVENTION EDUCATIONAL-PROGRAMS FOR HIGH-RISK WOMEN - A METAANALYSIS

Objective: To evaluate whether preterm-birth prevention educational pr ograms are effective at reducing neonatal mortality, low birth weight (LBW), and preterm delivery. Data Sources: A MEDLINE literature search of English-language studies was performed, supplemented by a bibliogr aphy search of original research and review articles to locate studies assessing preterm-birth prevention programs. Method of Study Selectio n: We identified 31 studies that reported results from trials evaluati ng preterm-birth prevention programs. From this group, only the six ra ndomized controlled trials evaluating preterm-birth prevention educati on programs satisfied criteria of homogeneity to be included in a meta -analysis. One of these six studies was a subset of another study and was excluded except when reporting outcomes that were not included in the larger report. Data Extraction and Synthesis: Two independent revi ewers assessed study methodology and identified the following outcomes : LBW frequency, preterm birth frequency, neonatal survival, birth wei ght, gestational age at delivery, and preterm labor diagnosis rates. W hen data were combined using meta-analytic techniques, no significant benefits were found for preterm-birth education programs in preventing neonatal death (cumulative relative risk [RR] 1.00, 95% confidence in terval [CI] 0.99-1.01), LBW rates (RR 0.99, 95% CI 0.88-1.11), or pret erm delivery rates (RR 1.08, 95% CI 0.92-1.27). The only statistically significant effect of preterm birth education programs appears to be an increase in the frequency at which preterm labor is diagnosed (RR 1 .71, 95% CI 1.41-2.08). Conclusion: Preterm-birth prevention education al programs appear to have little benefit in reducing preterm birth an d may result in an increased rate of diagnosis of preterm labor.