THE WEST LOS-ANGELES PRETERM BIRTH PREVENTION PROJECT .1. PROGRAM IMPACT ON HIGH-RISK WOMEN

OBJECTIVE: The primary objective of this prospective study was to test whether preterm birth prevention education plus increased clinic visi ts and selected prophylactic interventions reduce preterm birth. STUDY DESIGN: Eight West Los Angeles prenatal county clinics, comparable wi th respect to selected demographics, were randomized to be either expe rimental or control clinics. High-risk patients in all clinics were id entified with a risk scoring system derived from a similar population. High-risk patients (N = 1774) in experimental clinics were offered a program of education and more frequent visits and were randomized to r eceive various secondary intervention protocols in addition to the bas ic interventions of education and more frequent visits. Control clinic patients (N = 880) received standard county care. RESULTS: Preterm bi rth rates were 19% lower among the experimental high-risk patients 7.4 % vs 9.1%), and differences were significant (p < 0.05) when preterm r isk was taken into account. There was no evidence to suggest that the secondary interventions provided added benefit over the primary interv ention protocol of preterm birth prevention education and increased vi sits. CONCLUSION: The 19% reduction in preterm birth rate observed in the experimental clinics suggest an overall program benefit from a pro tocol that offered education, more frequent visits, and greater attent ion given to patients while the selected interventions were applied.