Psychological prevention of early pre-term birth: A reliable benefit

Objectives: After a previous study had shown the existence of psychological risk factors of pre-term delivery, we designed a study aimed at assessing the effect of psychotherapeutic support of pregnant women hospitalised with pre-term labour, followed by a second multicentric study aimed at demonstr ating the reliability of such an intervention. Methods: Both studies were c onducted in two successive cohorts of patients hospitalised with pre-term l abour at 18- 35 weeks of gestation. The initial study comprised 157 patient s in each group, whereas the reliability study comprised 191 patients in th e experimental group versus 202 in the control group. In each experimental group, the patients were offered psychotherapeutic support in addition to t he usual clinical management. The psychological support included interviews with a psychologist and a collaborative work plan implemented with the nur sing staff. Results: The analysis, conducted in the 'intention to treat' ma nner, shows a significant decrease in the early pre-term birth rate (<35 we eks) from 25.7 to 5.9% (p < 0.0001). After controlling for confounding fact ors, the adjusted relative risk was 0.16 [95% confidence interval (CI) = 0. 07-0.37]. These results were confirmed, at a lesser level, in the reliabili ty study, where the early pre-term birth rate changed from 15.7 to 7.2% (p < 0.02) and the adjusted relative risk was 0.35 (95% CI = 0.16-0.78). Concl usion: This study offers new and major results related to the prevention of delivery before 35 weeks of gestation, both in the initial study as well a s in the reliability study. Thus, providing this type of psychological supp ort to women hospitalised for pre-term labour, in the context of antenatal care, can help to avoid early pre-term births and their complications in te rms of brain damage and neuropsychological development. Copyright (C) 2001 S. Karger AG. Basel.