Prematurity Prevention Programs: An Analysis of Successes and Failures

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Abstract

OBJECTIVE

Our purpose was to assess the long-term results of established prematurity prevention programs.

STUDY DESIGN

A population cohort of pregnant women from two major urban health care organizations were examined. Rates and cost-benefit analysis of prematurity and patient, system, or physician failures were analyzed. During 1990 1143 pregnant women were prospectively reviewed.

RESULTS

A total of 11.8% of the mothers were high risk and responsible for 108 (50.2%) of the preterm deliveries. The preterm birth rate of all enrollees was 4.6%. One percent of the preterm neonates required level III care for complications. The average charge for a 35 week infant was 18 times, and a 36 week infant was five times more costly than a term infant. Patient, physician, and health care system failures occurred at different rates.

CONCLUSIONS

This preterm prevention program resulted in low preterm birth rates. Potentially preventable preterm births most often occurred as a result of patient and physician failures. (AM J OBSTET GYNECOL 1994;170:744-50.)

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