Materiały źródłowe

• #1 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth. Infants born at earlier gestational ages, especially 32 0/7 weeks, have the highest mortality and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics. Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority, can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact.

• #2

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #3

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #4 LSHTM LSHTM Research Online

  https://researchonline.lshtm.ac.uk/1878065/

  This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. […] Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. […] Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness.

• #5

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #6 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #7 Preterm birth – Wikipedia

  https://en.wikipedia.org/wiki/Preterm_birth

  Preterm birth complicates 5-18% of births worldwide. […] In Europe and many developed countries the preterm birth rate is generally 5-9%, while in the U.S. from 2007 to 2022 the rate fluctuated from 9.6 to 10.5 percent. […] About 75% of nearly a million deaths due to preterm delivery would survive if provided warmth, breastfeeding, treatments for infection, and breathing support. […] Complications from preterm births resulted in 740,000 deaths in 2013, down from 1.57 million in 1990.

• #8 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  Globally, complications of preterm birth are among the most common cause of neonatal mortality. In Ethiopia, the neonatal mortality reduction is not worthy of attention. Hence, this study reviewed the prevalence of preterm birth and factors associated with preterm birth in Ethiopia. […] The overall pooled prevalence of preterm birth in Ethiopia was 10.48% (95% CI: 7.9812.99). […] The pooled national level prevalence of preterm birth in Ethiopia is high. Socio demographic, nutritional, health care, obstetric and gynecologic, chronic illness and medical conditions, behavioral and lifestyle factors are the major associated factors of preterm birth in Ethiopia. […] The pooled effect shows that rural residents were 2.34 (AOR=2.34, 95% CI: 1.354.05, I-squared=0.0%) times likely to give birth before 37week of gestation compared to urban residents.

• #9

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #10 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815

  Background: The worldwide incidence of preterm births is increasing, and the risks of adverse outcomes for preterm infants significantly increase with shorter gestation, resulting in a substantial socioeconomic burden. Limited epidemiological studies have been conducted in China regarding the incidence and spatiotemporal trends of preterm births. […] Objective: This study aims to assess the incidence rates of preterm birth, very preterm birth, and extremely preterm birth; elucidate their spatiotemporal distribution; and investigate the risk factors associated with preterm birth. […] Results: The analysis incorporated data from 13,256,743 live births. We identified 754,268 preterm infants and 12,502,475 full-term infants. The incidences of preterm birth, very preterm birth, and extremely preterm birth were 5.69 per 100 births, 4.46 per 1000 births, and 4.83 per 10,000 births, respectively. The overall incidence of preterm birth increased from 5.12% in 2014 to 6.38% in 2021.

• #11 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815

  The incidence of extremely preterm birth increased from 4.10 per 10,000 births in 2014 to 8.09 per 10,000 births in 2021. […] Furthermore, adjusted odds ratios revealed that advanced maternal age, multiple pregnancies, and male infants were associated with an increased risk of preterm birth, whereas childbirth in the autumn season was associated with a protective effect against preterm birth. […] The incidence of preterm birth in southern China exhibited an upward trend, closely linked to enhancements in the care capabilities for high-risk pregnant women and critically ill newborns. […] Consequently, there is a pressing need to augment public health investments aimed at mitigating the risk factors associated with preterm birth, thereby alleviating the socioeconomic burden it imposes.

• #12 Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand | Liabsuetrakul | Journal of Health Science and Medical Research

  https://www.jhsmr.org/index.php/jhsmr/article/view/33

  Objective: To assess the prevalence and management of preterm birth and low birth weight (LBW) infants, including the exploration of known risk factors for preterm birth and LBW, recorded in field testing of a web-based surveillance system of maternal-newborn health in southern Thailand. […] The incidences of preterm birth and LBW were 5.6% and 9.8%, respectively. Maternal age, parity, preeclampsia, antenatal care visits, birth attendant and type of hospital were significantly associated with the incidence of preterm birth or LBW. […] The incidence of preterm and LBW births and their management can be monitored in a timely way from a web-based surveillance system.

• #13 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34-36 weeks gestation). […] This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth. […] Surveillance of preterm birth is essential for informing and evaluating clinical practices, research, programs, and policies aimed at reducing infant morbidity and mortality. Surveillance and epidemiologic analyses can measure the contribution of preterm birth to infant morbidity and mortality, identify populations at highest risk, detect changes in obstetric practices, and guide the development, implementation, and evaluation of programs.

• #14 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Increases in the singleton preterm birth rate since 1990 have been almost entirely due to infants born late preterm. During 1990-2006, the late preterm birth rate for singleton births increased 20.9%, from 6.7% to 8.1%. […] Although the reasons for the increasing rates of moderate preterm and late preterm birth during the last two decades are not well understood, several theories have been postulated. These include improved risk assessment and timing for maternal and fetal disorders, more elective inductions and caesarean sections to reduce adverse fetal outcomes, increasing maternal age (35 years), and increasing rates of multiple gestations. […] Concern about the practice of elective induction or caesarean delivery without medical indication prompted the March of Dimes to launch a national campaign, Healthy Babies are Worth the Wait, to raise awareness among patients and providers on the importance of preventing non-indicated intervention. […] Late preterm birth accounts for the vast majority of preterm births in the USA and for the rise in the national preterm birth rate over the past two decades. Late and moderate preterm infants are both physiologically and developmentally immature and have higher risks for morbidity and mortality compared with infants born at term.

• #15

  https://ibis.utah.gov/ibisph-view/indicator/view/VerPreBrth.html?PrinterFriendly=x

  Premature birth is a serious health problem. Premature babies are at an increased risk for newborn health complications, as well as lasting disabilities such as mental retardation, cerebral palsy, lung and gastrointestinal problems, vision and hearing loss, and even death. About 12.5 percent of babies (more than half a million per year) in the United States are born prematurely. For reasons that are not fully understood, the rate of premature birth has increased by more than 30 percent since 1981. […] Reduce very preterm or live births at less than 32 weeks of gestation U.S. target: 1.8 percent. […] Multiple baby pregnancies put the babies at a higher risk of preterm birth.

• #16 The epidemiology of preterm birth. – NeL.edu

  https://www.nel.edu/the-epidemiology-of-preterm-birth-2025/

  Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. […] The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. […] Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. […] Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described.

• #17 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815

  The incidence of extremely preterm birth increased from 4.10 per 10,000 births in 2014 to 8.09 per 10,000 births in 2021. […] Furthermore, adjusted odds ratios revealed that advanced maternal age, multiple pregnancies, and male infants were associated with an increased risk of preterm birth, whereas childbirth in the autumn season was associated with a protective effect against preterm birth. […] The incidence of preterm birth in southern China exhibited an upward trend, closely linked to enhancements in the care capabilities for high-risk pregnant women and critically ill newborns. […] Consequently, there is a pressing need to augment public health investments aimed at mitigating the risk factors associated with preterm birth, thereby alleviating the socioeconomic burden it imposes.

• #18 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #19 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34-36 weeks gestation). […] This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth. […] Surveillance of preterm birth is essential for informing and evaluating clinical practices, research, programs, and policies aimed at reducing infant morbidity and mortality. Surveillance and epidemiologic analyses can measure the contribution of preterm birth to infant morbidity and mortality, identify populations at highest risk, detect changes in obstetric practices, and guide the development, implementation, and evaluation of programs.

• #20 Preterm birth disparities | SF.gov

  https://www.sf.gov/data–preterm-birth-disparities

  Over the past 10 years, in San Francisco, risk of preterm birth varied significantly by race-ethnicity. […] Risk of preterm birth was about 30 percent higher for Asian and Latino/a pregnant people. […] Risk of preterm birth for Black or African American pregnant people was 200 percent higher. […] San Francisco has a worsening preterm birth disparity for lower income groups with public health insurance. […] In 2020-2022, people with public insurance were 30% more likely to have a preterm birth than people with private insurance. People with public insurance were 200 percent more likely to have a very preterm birth, before 32 weeks of pregnancy, than people with private insurance. […] In San Francisco, risk of preterm birth varies significantly by hospital, housing, access to adequate prenatal care, and food program participation.

• #21 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In 2023, there were 5,279 preterm births in Oklahoma, representing 11.0% of live births. […] In 2020-2023, 30 Oklahoma counties had a preterm birth rate higher than the state rate of 11.4%. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for Black infants (15.9%), followed by American Indian/Alaska Natives (11.3%), Whites (11.0%), Hispanics (10.3%) and Asian/Pacific Islanders (10.3%). […] Rather than having one cause, preterm birth seems to be triggered by multiple, interacting biologic and environmental factors. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for women ages 40 and older (17.0%), followed by women ages 30-39 (12.7%), under age 20 (11.3%) and ages 20-29 (10.4%). […] In 2022, 15.2% of women of childbearing age reported smoking in Oklahoma. Smoking is an important determinant of health and a significant factor contributing to preterm births.

• #22 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth. Infants born at earlier gestational ages, especially 32 0/7 weeks, have the highest mortality and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics. Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority, can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact.

• #23 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In 2023, there were 5,279 preterm births in Oklahoma, representing 11.0% of live births. […] In 2020-2023, 30 Oklahoma counties had a preterm birth rate higher than the state rate of 11.4%. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for Black infants (15.9%), followed by American Indian/Alaska Natives (11.3%), Whites (11.0%), Hispanics (10.3%) and Asian/Pacific Islanders (10.3%). […] Rather than having one cause, preterm birth seems to be triggered by multiple, interacting biologic and environmental factors. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for women ages 40 and older (17.0%), followed by women ages 30-39 (12.7%), under age 20 (11.3%) and ages 20-29 (10.4%). […] In 2022, 15.2% of women of childbearing age reported smoking in Oklahoma. Smoking is an important determinant of health and a significant factor contributing to preterm births.

• #24 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815

  The incidence of extremely preterm birth increased from 4.10 per 10,000 births in 2014 to 8.09 per 10,000 births in 2021. […] Furthermore, adjusted odds ratios revealed that advanced maternal age, multiple pregnancies, and male infants were associated with an increased risk of preterm birth, whereas childbirth in the autumn season was associated with a protective effect against preterm birth. […] The incidence of preterm birth in southern China exhibited an upward trend, closely linked to enhancements in the care capabilities for high-risk pregnant women and critically ill newborns. […] Consequently, there is a pressing need to augment public health investments aimed at mitigating the risk factors associated with preterm birth, thereby alleviating the socioeconomic burden it imposes.

• #25 The epidemiology of preterm birth. – NeL.edu

  https://www.nel.edu/the-epidemiology-of-preterm-birth-2025/

  Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. […] The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. […] Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. […] Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described.

• #26 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  Globally, complications of preterm birth are among the most common cause of neonatal mortality. In Ethiopia, the neonatal mortality reduction is not worthy of attention. Hence, this study reviewed the prevalence of preterm birth and factors associated with preterm birth in Ethiopia. […] The overall pooled prevalence of preterm birth in Ethiopia was 10.48% (95% CI: 7.9812.99). […] The pooled national level prevalence of preterm birth in Ethiopia is high. Socio demographic, nutritional, health care, obstetric and gynecologic, chronic illness and medical conditions, behavioral and lifestyle factors are the major associated factors of preterm birth in Ethiopia. […] The pooled effect shows that rural residents were 2.34 (AOR=2.34, 95% CI: 1.354.05, I-squared=0.0%) times likely to give birth before 37week of gestation compared to urban residents.

• #27 The epidemiology of preterm birth. – NeL.edu

  https://www.nel.edu/the-epidemiology-of-preterm-birth-2025/

  Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. […] The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. […] Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. […] Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described.

• #28 The epidemiology of preterm birth. – NeL.edu

  https://www.nel.edu/the-epidemiology-of-preterm-birth-2025/

  Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. […] The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. […] Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. […] Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described.

• #29 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In Oklahoma in 2023, 9.2% of singleton births were preterm, compared to 66.6% of multiple births. […] Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes. […] In Oklahoma, 44.7% of women of childbearing age were obese in 2022. […] In 2021, about 1 in 5 women of childbearing age (19.0%) was uninsured in Oklahoma. […] Other factors contributing to preterm birth include: infection (especially genito-urinary), diabetes mellitus, hypertension, late or no prenatal care, alcohol and illicit drug use, and social determinants of health. […] Preterm birth, along with low birth weight babies, make up the second leading cause of infant deaths after birth defects. […] When causes of death related to preterm birth are grouped together, preterm-related causes account for 34.8% of infant deaths in Oklahoma. […] The annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in Oklahoma is an estimated $54,000.

• #30 Preterm birth disparities | SF.gov

  https://www.sf.gov/data–preterm-birth-disparities

  In 2020-2022, the percent preterm was about two times greater for people living in public housing or Single Resident Occupancy (SRO) rooms and people with inadequate prenatal care. […] Preterm birth is not evenly distributed across San Francisco zip codes. […] Zip code 94130 (Treasure Island) has the highest rate of preterm birth in San Francisco. One out of every 5 births on Treasure Island were preterm in 2018-2022. […] In 2018-2022, the Treasure Island (94130), Excelsior (94112), and Bayview (94124) zip codes had a significantly higher percent preterm than the Pacific Heights (94109) zip code.

• #31 Preterm Labor and Birth: Background, Pathophysiology, Epidemiology and Risk Factors

  https://emedicine.medscape.com/article/260998-overview

  Preterm birth, defined as birth between 20 0/7 and 36 6/7 weeks of gestation, is the leading cause of neonatal mortality in nonanomalous fetuses and is the leading cause of long-term neurodevelopmental impairment. It is estimated that 15 million preterm births occur globally each year. Despite considerable investment in research and strategies to prevent preterm birth, little impact has been made on this goal, and there have not been substantial changes in the rates of preterm birth over the past decade. […] In the United States, preterm birth complicates approximately 10.4% of pregnancies. This incidence has not changed substantially over the past several decades. Risk factors for preterm birth include a history of prior preterm birth, multifetal gestations, African descent/Black race, lower socioeconomic status and socioeconomic deprivation, smoking, drug use, short interpregnancy interval, low and high maternal ages, single marital status, congenital uterine anomalies, and low prepregnancy weight.

• #32 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  This study was conducted to assess the magnitude of preterm birth and its associated factors in public hospitals in the east Gojjam zone. […] The proportion of preterm birth in this study was found to be 13.2%. […] The education status of mothers were significant factors of preterm. […] Mothers with multifetal gestation were 3.30 times more likely to have a preterm birth than mothers without multifetal gestation. […] This study revealed a significant association between pregnancy-induced hypertension and preterm birth. […] Being HIV positive was significantly associated with preterm birth. […] The proportion of preterm birth in public hospitals in the east Gojjam zone is 13.7%.

• #33 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In Oklahoma in 2023, 9.2% of singleton births were preterm, compared to 66.6% of multiple births. […] Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes. […] In Oklahoma, 44.7% of women of childbearing age were obese in 2022. […] In 2021, about 1 in 5 women of childbearing age (19.0%) was uninsured in Oklahoma. […] Other factors contributing to preterm birth include: infection (especially genito-urinary), diabetes mellitus, hypertension, late or no prenatal care, alcohol and illicit drug use, and social determinants of health. […] Preterm birth, along with low birth weight babies, make up the second leading cause of infant deaths after birth defects. […] When causes of death related to preterm birth are grouped together, preterm-related causes account for 34.8% of infant deaths in Oklahoma. […] The annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in Oklahoma is an estimated $54,000.

• #34 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  The pooled estimate (AOR=2.59, 95% CI: 1.853.64, I-square=54.1%) shows the existence of statistically significant association between iron deficiency anemia and PTB. […] The pooled estimate shows that those with 4 ANC visits were 2.34 (AOR=2.34, 95%CI: 1.733.33, I-squared=54.7%) times likely to experience PTB compared to their counterparts. […] The estimated pooled values shows that those with less than 2 years birth interval were 2.91 (AOR=2.91, 95%CI: 1.974.30, I-squared=0.0%) times likely to deliver preterm compared to birth interval of more than or equal to 2 years. […] The pooled estimate shows those mothers with chronic illness were nearly four (AOR=4.89, 95%CI: 3.127.66, I-squared=0.0%) times likely to give PTB compared those free of chronic diseases. […] Support during pregnancy reduced the chance of preterm delivery.

• #35

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #36

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #37 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #38 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  The pooled estimate (AOR=2.59, 95% CI: 1.853.64, I-square=54.1%) shows the existence of statistically significant association between iron deficiency anemia and PTB. […] The pooled estimate shows that those with 4 ANC visits were 2.34 (AOR=2.34, 95%CI: 1.733.33, I-squared=54.7%) times likely to experience PTB compared to their counterparts. […] The estimated pooled values shows that those with less than 2 years birth interval were 2.91 (AOR=2.91, 95%CI: 1.974.30, I-squared=0.0%) times likely to deliver preterm compared to birth interval of more than or equal to 2 years. […] The pooled estimate shows those mothers with chronic illness were nearly four (AOR=4.89, 95%CI: 3.127.66, I-squared=0.0%) times likely to give PTB compared those free of chronic diseases. […] Support during pregnancy reduced the chance of preterm delivery.

• #39 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  This study was conducted to assess the magnitude of preterm birth and its associated factors in public hospitals in the east Gojjam zone. […] The proportion of preterm birth in this study was found to be 13.2%. […] The education status of mothers were significant factors of preterm. […] Mothers with multifetal gestation were 3.30 times more likely to have a preterm birth than mothers without multifetal gestation. […] This study revealed a significant association between pregnancy-induced hypertension and preterm birth. […] Being HIV positive was significantly associated with preterm birth. […] The proportion of preterm birth in public hospitals in the east Gojjam zone is 13.7%.

• #40

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #41 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  The pooled estimate (AOR=2.59, 95% CI: 1.853.64, I-square=54.1%) shows the existence of statistically significant association between iron deficiency anemia and PTB. […] The pooled estimate shows that those with 4 ANC visits were 2.34 (AOR=2.34, 95%CI: 1.733.33, I-squared=54.7%) times likely to experience PTB compared to their counterparts. […] The estimated pooled values shows that those with less than 2 years birth interval were 2.91 (AOR=2.91, 95%CI: 1.974.30, I-squared=0.0%) times likely to deliver preterm compared to birth interval of more than or equal to 2 years. […] The pooled estimate shows those mothers with chronic illness were nearly four (AOR=4.89, 95%CI: 3.127.66, I-squared=0.0%) times likely to give PTB compared those free of chronic diseases. […] Support during pregnancy reduced the chance of preterm delivery.

• #42 Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03271-6

  The pooled estimate (AOR=2.59, 95% CI: 1.853.64, I-square=54.1%) shows the existence of statistically significant association between iron deficiency anemia and PTB. […] The pooled estimate shows that those with 4 ANC visits were 2.34 (AOR=2.34, 95%CI: 1.733.33, I-squared=54.7%) times likely to experience PTB compared to their counterparts. […] The estimated pooled values shows that those with less than 2 years birth interval were 2.91 (AOR=2.91, 95%CI: 1.974.30, I-squared=0.0%) times likely to deliver preterm compared to birth interval of more than or equal to 2 years. […] The pooled estimate shows those mothers with chronic illness were nearly four (AOR=4.89, 95%CI: 3.127.66, I-squared=0.0%) times likely to give PTB compared those free of chronic diseases. […] Support during pregnancy reduced the chance of preterm delivery.

• #43 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  This study was conducted to assess the magnitude of preterm birth and its associated factors in public hospitals in the east Gojjam zone. […] The proportion of preterm birth in this study was found to be 13.2%. […] The education status of mothers were significant factors of preterm. […] Mothers with multifetal gestation were 3.30 times more likely to have a preterm birth than mothers without multifetal gestation. […] This study revealed a significant association between pregnancy-induced hypertension and preterm birth. […] Being HIV positive was significantly associated with preterm birth. […] The proportion of preterm birth in public hospitals in the east Gojjam zone is 13.7%.

• #44

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #45

  https://www.ijrcog.org/index.php/ijrcog/article/view/3800

  Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. […] Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. […] Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. […] Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.

• #46 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In 2023, there were 5,279 preterm births in Oklahoma, representing 11.0% of live births. […] In 2020-2023, 30 Oklahoma counties had a preterm birth rate higher than the state rate of 11.4%. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for Black infants (15.9%), followed by American Indian/Alaska Natives (11.3%), Whites (11.0%), Hispanics (10.3%) and Asian/Pacific Islanders (10.3%). […] Rather than having one cause, preterm birth seems to be triggered by multiple, interacting biologic and environmental factors. […] During 2021-2023 (average) in Oklahoma, preterm birth rates were highest for women ages 40 and older (17.0%), followed by women ages 30-39 (12.7%), under age 20 (11.3%) and ages 20-29 (10.4%). […] In 2022, 15.2% of women of childbearing age reported smoking in Oklahoma. Smoking is an important determinant of health and a significant factor contributing to preterm births.

• #47 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In Oklahoma in 2023, 9.2% of singleton births were preterm, compared to 66.6% of multiple births. […] Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes. […] In Oklahoma, 44.7% of women of childbearing age were obese in 2022. […] In 2021, about 1 in 5 women of childbearing age (19.0%) was uninsured in Oklahoma. […] Other factors contributing to preterm birth include: infection (especially genito-urinary), diabetes mellitus, hypertension, late or no prenatal care, alcohol and illicit drug use, and social determinants of health. […] Preterm birth, along with low birth weight babies, make up the second leading cause of infant deaths after birth defects. […] When causes of death related to preterm birth are grouped together, preterm-related causes account for 34.8% of infant deaths in Oklahoma. […] The annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in Oklahoma is an estimated $54,000.

• #48 Marijuana Use While Pregnant Linked to Preterm Birth, Low Birth Weight | Health | leader-call.com

  https://www.leader-call.com/lifestyles/health/marijuana-use-while-pregnant-linked-to-preterm-birth-low-birth-weight/article_434a6a75-63ed-581f-a835-e63edb64b5ae.html

  Using marijuana while pregnant raises the risk of early delivery and low birth weight. […] A large review of 51 studies linked marijuana use during pregnancy to an increased risk of early delivery, low birth weight and even death. […] The new study found that marijuana use during pregnancy was linked to a 52% higher risk of preterm birth (before 37 weeks). […] A 75% higher risk of low birth weight (under 5.5 pounds). […] A 29% higher risk of infant death. […] This review found that as more studies are conducted with consistent results, there is more certainty that there is an association between prenatal exposure to cannabis and adverse birth outcomes. […] Ideally, its best not to be exposed to THC, which is the psychoactive ingredient of cannabis, no matter what form youre using.

• #49 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In Oklahoma in 2023, 9.2% of singleton births were preterm, compared to 66.6% of multiple births. […] Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes. […] In Oklahoma, 44.7% of women of childbearing age were obese in 2022. […] In 2021, about 1 in 5 women of childbearing age (19.0%) was uninsured in Oklahoma. […] Other factors contributing to preterm birth include: infection (especially genito-urinary), diabetes mellitus, hypertension, late or no prenatal care, alcohol and illicit drug use, and social determinants of health. […] Preterm birth, along with low birth weight babies, make up the second leading cause of infant deaths after birth defects. […] When causes of death related to preterm birth are grouped together, preterm-related causes account for 34.8% of infant deaths in Oklahoma. […] The annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in Oklahoma is an estimated $54,000.

• #50

  https://journals.lww.com/environepidem/fulltext/2020/08000/oil_and_gas_production_and_spontaneous_preterm.1.aspx

  Recent studies report an association between preterm birth and exposure to unconventional oil and gas wells. […] Our objective was to determine whether exposure to well sites was associated with increased odds of spontaneous preterm birth (delivery at 37 weeks). […] We found evidence that exposure to oil and gas well sites is associated with increased risk of spontaneous preterm birth. […] We examined whether exposure to well sites was associated with preterm birth risk. […] We observed an association between preterm birth and exposure to oil and gas well sites. […] We found evidence that proximity to wells in preproduction is associated with higher exposure to PM10 and PM2.5, which supports our hypothesis that proximity to wells in preproduction confers risk. […] We found an association between exposure to oil and gas well sites and odds of spontaneous preterm birth at 2031 weeks in the San Joaquin Valley, CA. This study adds to limited evidence that oil and gas extraction activities have adverse impacts on reproductive health.

• #51 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815/

  In our study, we observed that season had a notable impact on PTBs. […] In general, there were 2 peaks in the incidence of PTBs during summer (June 1 to August 31) and winter (December 1 to February 30). […] Our findings suggest that, despite a year-on-year increase in the incidence of PTBs, it remains below the global average, which bodes well for the advancement of public health initiatives in China.

• #52

  https://link.springer.com/article/10.1007/s43032-023-01287-9

  Preterm birth (PTB), defined as the birth of a child before 37 completed weeks gestation, affects approximately 11% of live births and is the leading cause of death in children under 5 years. […] Much research has aimed to establish the biological mechanisms underlying PTB often through identification of genetic markers for PTB risk. […] Genetic studies have identified genes within inflammatory, immunological, tissue remodeling, endocrine, metabolic, and vascular pathways that may be involved in PTB. […] The heritability of PTB has been assessed through large intergenerational studies, as well as in studies of monozygotic twins and siblings. […] There is a 20% increased risk of PTB if a mother was born preterm herself; this risk is inversely correlated to the mothers gestational age at birth.

• #53

  https://link.springer.com/article/10.1007/s43032-023-01287-9

  Furthermore, women with sisters who delivered preterm babies are at an 80% increased risk of delivering preterm themselves. […] Twin studies have also suggested that genetics account for 17-36% of PTB risk. […] The existing body of research supports a possible role of inflammatory, immunological, metabolic, endocrine, tissue remodeling, vascular, and endothelial pathways in PTB, providing some insight into the pathophysiological processes underpinning this disease. […] This review has summarized the body of literature regarding the role of genetics in PTB and has highlighted the need for conducting future research with large sample sizes, detailed phenotyping, and integrated multi-omics analyses with clinical biomarkers.

• #54

  https://link.springer.com/article/10.1007/s43032-023-01287-9

  Furthermore, women with sisters who delivered preterm babies are at an 80% increased risk of delivering preterm themselves. […] Twin studies have also suggested that genetics account for 17-36% of PTB risk. […] The existing body of research supports a possible role of inflammatory, immunological, metabolic, endocrine, tissue remodeling, vascular, and endothelial pathways in PTB, providing some insight into the pathophysiological processes underpinning this disease. […] This review has summarized the body of literature regarding the role of genetics in PTB and has highlighted the need for conducting future research with large sample sizes, detailed phenotyping, and integrated multi-omics analyses with clinical biomarkers.

• #55 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815

  Data from 13 studies conducted in the United States and Europe revealed that 54.6% of PTBs were male infants, with a risk ratio of 1.14 (95% CI 1.11-1.17) for PTBs of male infants compared with female infants, aligning with our findings. […] In this study, we investigated the prevalence and risk factors associated with preterm infants in southern China, approaching the analysis both from a spatiotemporal perspective and using a substantial data set.

• #56 COVID-19 during pregnancy associated with preterm birth | Epidemiology & Biostatistics

  https://epibiostat.ucsf.edu/news/covid-19-during-pregnancy-associated-preterm-birth

  Individuals who contract COVID-19 while pregnant face a higher risk of having a very preterm birth, as well as any preterm birth, according to a large study led by researchers at UC San Francisco. […] Risk of very preterm birth, which occurs at less than 32 weeks of gestation, was 60 percent higher for people infected with COVID-19 at some point in their pregnancy, while the risk of giving birth at less than 37 weeks (all preterm births) was 40 percent higher in those with infection. […] The UCSF study was the first of its kind large enough to identify the risks of COVID-19 by specific subtype of preterm birth, as well as by race, ethnicity, and insurance status. […] The preterm birth rate among birthing people with a COVID-19 diagnosis was 11.8 percent compared with 8.7 percent among those without COVID-19.

• #57 COVID-19 during pregnancy associated with preterm birth | Epidemiology & Biostatistics

  https://epibiostat.ucsf.edu/news/covid-19-during-pregnancy-associated-preterm-birth

  Individuals who contract COVID-19 while pregnant face a higher risk of having a very preterm birth, as well as any preterm birth, according to a large study led by researchers at UC San Francisco. […] Risk of very preterm birth, which occurs at less than 32 weeks of gestation, was 60 percent higher for people infected with COVID-19 at some point in their pregnancy, while the risk of giving birth at less than 37 weeks (all preterm births) was 40 percent higher in those with infection. […] The UCSF study was the first of its kind large enough to identify the risks of COVID-19 by specific subtype of preterm birth, as well as by race, ethnicity, and insurance status. […] The preterm birth rate among birthing people with a COVID-19 diagnosis was 11.8 percent compared with 8.7 percent among those without COVID-19.

• #58 COVID-19 during pregnancy associated with preterm birth | Epidemiology & Biostatistics

  https://epibiostat.ucsf.edu/news/covid-19-during-pregnancy-associated-preterm-birth

  Having comorbidities along with COVID-19 infection increased the risk of preterm birth. Individuals with hypertension, diabetes and/or obesity as well as a COVID-19 diagnosis had a 160 percent higher risk of very preterm birth and a 100 percent higher risk of preterm birth compared to those without comorbidities or COVID-19. […] Researchers found that preterm birth rates didn’t vary by whether the births were spontaneous or medically-indicated, which may indicate multiple pathways between COVID-19 diagnosis and preterm birth. […] Limitations of the study included that it couldn’t determine when during pregnancy the individuals contracted COVID-19, or how serious the infections were.

• #59 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34-36 weeks gestation). […] This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth. […] Surveillance of preterm birth is essential for informing and evaluating clinical practices, research, programs, and policies aimed at reducing infant morbidity and mortality. Surveillance and epidemiologic analyses can measure the contribution of preterm birth to infant morbidity and mortality, identify populations at highest risk, detect changes in obstetric practices, and guide the development, implementation, and evaluation of programs.

• #60 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34-36 weeks gestation). […] This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth. […] Surveillance of preterm birth is essential for informing and evaluating clinical practices, research, programs, and policies aimed at reducing infant morbidity and mortality. Surveillance and epidemiologic analyses can measure the contribution of preterm birth to infant morbidity and mortality, identify populations at highest risk, detect changes in obstetric practices, and guide the development, implementation, and evaluation of programs.

• #61 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  To effectively implement and evaluate these prevention strategies, high-quality surveillance systems are needed to monitor preterm births, associated risk factors, and outcomes. Timely availability of and access to data sources, such as vital records, administrative data, and surveys, are important for monitoring risk factors and outcomes and informing program evaluation at local, state, and national levels. […] Several initiatives are underway to reduce preterm delivery and complications. One is CDCs Maternal and Child Health Epidemiology program. This program develops leadership and builds state, local, and tribal level capacity for surveillance, monitoring, and evaluation activities by assigning senior epidemiologists to work with communities.

• #62 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  To effectively implement and evaluate these prevention strategies, high-quality surveillance systems are needed to monitor preterm births, associated risk factors, and outcomes. Timely availability of and access to data sources, such as vital records, administrative data, and surveys, are important for monitoring risk factors and outcomes and informing program evaluation at local, state, and national levels. […] Several initiatives are underway to reduce preterm delivery and complications. One is CDCs Maternal and Child Health Epidemiology program. This program develops leadership and builds state, local, and tribal level capacity for surveillance, monitoring, and evaluation activities by assigning senior epidemiologists to work with communities.

• #63 LSHTM LSHTM Research Online

  https://researchonline.lshtm.ac.uk/1878065/

  This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. […] Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. […] Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness.

• #64 LSHTM LSHTM Research Online

  https://researchonline.lshtm.ac.uk/1878065/

  This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. […] Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. […] Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness.

• #65 The London Preterm Birth Surveillance Clinic | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/research/research-centres/london-preterm-birth-surveillance-clinic

  Under the leadership of Professor Andrew Shennan OBE, Tommy’s Preterm Birth Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. […] The clinic is dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. Experts state that rolling out this clinic’s model nationally could prevent around 9,000 premature births each year in the UK. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born too early. […] The preterm surveillance clinic is extra care for women more likely to have a preterm birth. It does not replace any other care you have. […] Women can be referred here if they have a higher risk of giving birth too early. This can be for a number of reasons, such as: previous birth before 34 weeks, previous late miscarriage, the 'waters’ (amniotic sac) have broken before 34 weeks in a previous pregnancy, previous surgery to the cervix after an abnormal smear test, an unusually shaped womb, women expecting more than 1 baby.

• #66 The London Preterm Birth Surveillance Clinic | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/research/research-centres/london-preterm-birth-surveillance-clinic

  Under the leadership of Professor Andrew Shennan OBE, Tommy’s Preterm Birth Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. […] The clinic is dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. Experts state that rolling out this clinic’s model nationally could prevent around 9,000 premature births each year in the UK. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born too early. […] The preterm surveillance clinic is extra care for women more likely to have a preterm birth. It does not replace any other care you have. […] Women can be referred here if they have a higher risk of giving birth too early. This can be for a number of reasons, such as: previous birth before 34 weeks, previous late miscarriage, the 'waters’ (amniotic sac) have broken before 34 weeks in a previous pregnancy, previous surgery to the cervix after an abnormal smear test, an unusually shaped womb, women expecting more than 1 baby.

• #67 The London Preterm Birth Surveillance Clinic | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/research/research-centres/london-preterm-birth-surveillance-clinic

  Under the leadership of Professor Andrew Shennan OBE, Tommy’s Preterm Birth Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. […] The clinic is dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. Experts state that rolling out this clinic’s model nationally could prevent around 9,000 premature births each year in the UK. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born too early. […] The preterm surveillance clinic is extra care for women more likely to have a preterm birth. It does not replace any other care you have. […] Women can be referred here if they have a higher risk of giving birth too early. This can be for a number of reasons, such as: previous birth before 34 weeks, previous late miscarriage, the 'waters’ (amniotic sac) have broken before 34 weeks in a previous pregnancy, previous surgery to the cervix after an abnormal smear test, an unusually shaped womb, women expecting more than 1 baby.

• #68 The London Preterm Birth Surveillance Clinic | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/research/research-centres/london-preterm-birth-surveillance-clinic

  Under the leadership of Professor Andrew Shennan OBE, Tommy’s Preterm Birth Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. […] The clinic is dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. Experts state that rolling out this clinic’s model nationally could prevent around 9,000 premature births each year in the UK. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born too early. […] The preterm surveillance clinic is extra care for women more likely to have a preterm birth. It does not replace any other care you have. […] Women can be referred here if they have a higher risk of giving birth too early. This can be for a number of reasons, such as: previous birth before 34 weeks, previous late miscarriage, the 'waters’ (amniotic sac) have broken before 34 weeks in a previous pregnancy, previous surgery to the cervix after an abnormal smear test, an unusually shaped womb, women expecting more than 1 baby.

• #69 Preterm birth surveillance clinic — Chelsea and Westminster Hospital NHS Foundation Trust

  https://www.chelwest.nhs.uk/services/maternity/pregnancy-birth/your-pregnancy/preterm-birth-surveillance-clinic

  At both Chelsea and Westminster Hospital and West Middlesex Hospital, we provide specialist care to pregnant women who are at higher risk of giving birth to their baby early (before 37 weeks of pregnancy). The clinics are dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. […] Prematurity is a major global issue and the most important cause of poor health and development in children and sadly, childhood death. Approximately, one in twelve women (8%) give birth to their baby before 37 weeks of pregnancy. […] The aim of our clinics is to prevent preterm labour and birth as far as is possible and where not possible to enhance care to reduce the complications of prematurity for your baby. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born early.

• #70 Preterm birth surveillance clinic — Chelsea and Westminster Hospital NHS Foundation Trust

  https://www.chelwest.nhs.uk/services/maternity/pregnancy-birth/your-pregnancy/preterm-birth-surveillance-clinic

  At both Chelsea and Westminster Hospital and West Middlesex Hospital, we provide specialist care to pregnant women who are at higher risk of giving birth to their baby early (before 37 weeks of pregnancy). The clinics are dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. […] Prematurity is a major global issue and the most important cause of poor health and development in children and sadly, childhood death. Approximately, one in twelve women (8%) give birth to their baby before 37 weeks of pregnancy. […] The aim of our clinics is to prevent preterm labour and birth as far as is possible and where not possible to enhance care to reduce the complications of prematurity for your baby. […] The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born early.

• #71 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  To effectively implement and evaluate these prevention strategies, high-quality surveillance systems are needed to monitor preterm births, associated risk factors, and outcomes. Timely availability of and access to data sources, such as vital records, administrative data, and surveys, are important for monitoring risk factors and outcomes and informing program evaluation at local, state, and national levels. […] Several initiatives are underway to reduce preterm delivery and complications. One is CDCs Maternal and Child Health Epidemiology program. This program develops leadership and builds state, local, and tribal level capacity for surveillance, monitoring, and evaluation activities by assigning senior epidemiologists to work with communities.

• #72 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  To effectively implement and evaluate these prevention strategies, high-quality surveillance systems are needed to monitor preterm births, associated risk factors, and outcomes. Timely availability of and access to data sources, such as vital records, administrative data, and surveys, are important for monitoring risk factors and outcomes and informing program evaluation at local, state, and national levels. […] Several initiatives are underway to reduce preterm delivery and complications. One is CDCs Maternal and Child Health Epidemiology program. This program develops leadership and builds state, local, and tribal level capacity for surveillance, monitoring, and evaluation activities by assigning senior epidemiologists to work with communities.

• #73 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #74 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #75

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #76

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #77

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Globally, prematurity is the leading cause of death in children under the age of 5 years. […] WHO is committed to reducing the health problems and lives lost as a result of preterm birth, including working with Member States and partners to implement Every newborn: an action plan to end preventable deaths, adopted in May 2014 in the framework of the UN Secretary-Generals Global strategy for womens and childrens health; and strengthening the availability and quality of data on preterm births. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #78 Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand | Liabsuetrakul | Journal of Health Science and Medical Research

  https://www.jhsmr.org/index.php/jhsmr/article/view/33

  Objective: To assess the prevalence and management of preterm birth and low birth weight (LBW) infants, including the exploration of known risk factors for preterm birth and LBW, recorded in field testing of a web-based surveillance system of maternal-newborn health in southern Thailand. […] The incidences of preterm birth and LBW were 5.6% and 9.8%, respectively. Maternal age, parity, preeclampsia, antenatal care visits, birth attendant and type of hospital were significantly associated with the incidence of preterm birth or LBW. […] The incidence of preterm and LBW births and their management can be monitored in a timely way from a web-based surveillance system.

• #79 Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand | Liabsuetrakul | Journal of Health Science and Medical Research

  https://www.jhsmr.org/index.php/jhsmr/article/view/33

  Objective: To assess the prevalence and management of preterm birth and low birth weight (LBW) infants, including the exploration of known risk factors for preterm birth and LBW, recorded in field testing of a web-based surveillance system of maternal-newborn health in southern Thailand. […] The incidences of preterm birth and LBW were 5.6% and 9.8%, respectively. Maternal age, parity, preeclampsia, antenatal care visits, birth attendant and type of hospital were significantly associated with the incidence of preterm birth or LBW. […] The incidence of preterm and LBW births and their management can be monitored in a timely way from a web-based surveillance system.

• #80 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #81 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #82 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #83 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  Preterm birth is defined as babies born alive before 37 weeks of pregnancy or fewer than 259 days since the first day of a womans last menstrual period. Globally, 14.84 million babies were preterm births. Preterm infants are at risk for specific diseases related to the immaturity of various organ systems. This study aimed to assess the prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia. […] The overall prevalence of preterm birth in Ethiopia was 10.48%. […] The complication of preterm birth is a major risk factor of this mortality. […] The prediction and prevention of preterm birth is a major health care priority. […] During the neonatal period, preterm babies are at a higher risk of serious illness or death.

• #84 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #85 Preterm Birth | Maternal Infant Health | CDC

  https://www.cdc.gov/maternal-infant-health/preterm-birth/index.html

  Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. In 2022, preterm birth affected about 1 of every 10 infants born in the United States. […] The preterm birth rate declined 1% from 2021 to 2022, to 10.4%, following an increase of 4% from 2020 to 2021. However, racial and ethnic differences in preterm birth rates remain. In 2022, preterm birth among Black women (14.6%) was about 50% higher than White (9.4%) or Hispanic women (10.1%). […] Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2022, preterm birth and low birth weight accounted for about 14.0% of infant deaths (deaths before 1 year of age). […] Women who conceive through in vitro fertilization (IVF) or another assisted reproductive technology (ART) are at higher risk for preterm birth. This is primarily because they are more likely to be pregnant with more than one baby at a time. […] CDC’s Division of Reproductive Health recently expanded support to 36 Perinatal Quality Collaboratives (PQCs). Funding supports the capabilities of PQCs to improve the quality of perinatal care in their states. This includes efforts to reduce preterm birth.

• #86 mmnwa.com, Preterm Birth Surveillance and Prevention Program

  https://www.mfmnwa.com/preterm-birth-prevention

  Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. In the United States, approximately 12% (13.1% in the state of Arkansas) of all live births occur before term (37 weeks), and preterm labor preceded approximately 50% of these preterm births. […] One way to combat the complications of a premature delivery is early recognition of those pregnancies at highest risk for preterm delivery. […] We utilize innovative cervical length surveillance protocols, along with periodic fetal fibronectin screening, to help identify those women at risk for preterm labor.

• #87 Prematurity: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/975909-overview

  The mortality rate is high in developing countries, especially those of Sub-Saharan Africa. The perinatal mortality rate is 70 deaths per 1000 births; the neonatal mortality rate is 45 deaths per 1000 live births. Preterm birth is the strongest independent predictor of mortality in the United States. Preterm delivery accounts for 75-80% of all neonatal morbidity and mortality.

• #88 A profile of prematurity of Oklahoma | PeriStats | March of Dimes

  https://www.marchofdimes.org/peristats/reports/oklahoma/prematurity-profile

  In Oklahoma in 2023, 9.2% of singleton births were preterm, compared to 66.6% of multiple births. […] Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes. […] In Oklahoma, 44.7% of women of childbearing age were obese in 2022. […] In 2021, about 1 in 5 women of childbearing age (19.0%) was uninsured in Oklahoma. […] Other factors contributing to preterm birth include: infection (especially genito-urinary), diabetes mellitus, hypertension, late or no prenatal care, alcohol and illicit drug use, and social determinants of health. […] Preterm birth, along with low birth weight babies, make up the second leading cause of infant deaths after birth defects. […] When causes of death related to preterm birth are grouped together, preterm-related causes account for 34.8% of infant deaths in Oklahoma. […] The annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in Oklahoma is an estimated $54,000.

• #89 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK 8% babies are born preterm (before 37 weeks’ gestation), which is associated with high mortality and morbidity. Currently some women at risk of preterm birth are referred to a specialist Preterm Birth Prevention Clinic alongside standard care, while the majority are offered standard care only. Only 33 consultant-led hospitals have a specialist preterm clinic out of 187 hospitals offering UK obstetric care (Care et al., 2018). Guidance recommends a new 'Preterm Birth Surveillance Pathway’ (NHS England, 2019a) to standardise care and to reduce the preterm birth rate. This involves midwives assessing all women for their risk of preterm birth. Women at high or intermediate risk should be referred to a Preterm Birth Prevention Clinic alongside normal care, where they can be offered further screening tests and interventions. This pathway is in the NHS standard contract, meaning maternity providers should implement this by April 2020 (NHS England, 2019b). This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). Research question: To understand how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is successfully (and unsuccessfully) implemented. Aims and objectives Objectives: To identify contexts and mechanisms leading to both positive and negative outcomes in terms of implementation of the PBP. To understand the relationship between the contexts, mechanisms and outcomes in implementing the PBP. To identify and assess a range of implementation outcomes in implementing the PBP, and any unintended consequences. To determine optimal implementation theories for effective national uptake of PBP, to produce a set of recommendations to implement the pathway in a range of hospitals. […] This research will ensure the PBP is implemented effectively. This will help reduce preterm birth from 8% to 6% by 2025 (Department of Health, 2017), and reduce the annual NHS preterm birth cost of over one billion pounds (Mangham et al., 2009).

• #90 ABC of preterm birth. Epidemiology of preterm birth. The British Medical Journal 2004;329:675-678.

  https://ciane.net/id=1070/en

  ABC of preterm birth. Epidemiology of preterm birth. The British Medical Journal 2004;329:675-678. […] Preterm birth is a major challenge in perinatal health care. Most perinatal deaths occur in preterm infants, and preterm birth is an important risk factor for neurological impairment and disability. Preterm birth not only affects infants and their familiesproviding care for preterm infants, who may spend several months in hospital, has increasing cost implications for health services. […] Keywords : premature baby ; low birth weight ; perinatal death rates

• #91 JMIR Public Health and Surveillance – Spatiotemporal Characteristics and Risk Factors for All and Severity-Specific Preterm Births in Southern China, 2014-2021: Large Population-Based Study

  https://publichealth.jmir.org/2024/1/e48815/

  Background: The worldwide incidence of preterm births is increasing, and the risks of adverse outcomes for preterm infants significantly increase with shorter gestation, resulting in a substantial socioeconomic burden. Limited epidemiological studies have been conducted in China regarding the incidence and spatiotemporal trends of preterm births. […] Objective: This study aims to assess the incidence rates of preterm birth, very preterm birth, and extremely preterm birth; elucidate their spatiotemporal distribution; and investigate the risk factors associated with preterm birth. […] Results: The analysis incorporated data from 13,256,743 live births. We identified 754,268 preterm infants and 12,502,475 full-term infants. The incidences of preterm birth, very preterm birth, and extremely preterm birth were 5.69 per 100 births, 4.46 per 1000 births, and 4.83 per 10,000 births, respectively. The overall incidence of preterm birth increased from 5.12% in 2014 to 6.38% in 2021.

• #92 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth. Infants born at earlier gestational ages, especially 32 0/7 weeks, have the highest mortality and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics. Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority, can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact.

• #93 The global epidemiology of preterm birth – University of South Australia

  http://find.library.unisa.edu.au/discovery/fulldisplay/cdi_crossref_primary_10_1016_j_bpobgyn_2018_04_003/61USOUTHAUS_INST:UNISA

  Preterm birth affects approximately 11% of births worldwide. However, estimation is complicated by differences in measurement of gestational age, preterm definitions, as well as differences in data collection and reporting. […] Although many factors have been shown to increase the risk of spontaneous preterm birth, the majority of preterm births occur in women without a clear risk factor. […] Long-term studies have shown that the deleterious effects of preterm birth continue to affect health and welfare in adult life. […] Addressing preterm birth is critical to addressing neonatal and child mortality and morbidity, particularly in resource-poor settings.

• #94 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  Preterm birth is defined as babies born alive before 37 weeks of pregnancy or fewer than 259 days since the first day of a womans last menstrual period. Globally, 14.84 million babies were preterm births. Preterm infants are at risk for specific diseases related to the immaturity of various organ systems. This study aimed to assess the prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia. […] The overall prevalence of preterm birth in Ethiopia was 10.48%. […] The complication of preterm birth is a major risk factor of this mortality. […] The prediction and prevention of preterm birth is a major health care priority. […] During the neonatal period, preterm babies are at a higher risk of serious illness or death.

• #95 Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05517-5

  Preterm birth is defined as babies born alive before 37 weeks of pregnancy or fewer than 259 days since the first day of a womans last menstrual period. Globally, 14.84 million babies were preterm births. Preterm infants are at risk for specific diseases related to the immaturity of various organ systems. This study aimed to assess the prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia. […] The overall prevalence of preterm birth in Ethiopia was 10.48%. […] The complication of preterm birth is a major risk factor of this mortality. […] The prediction and prevention of preterm birth is a major health care priority. […] During the neonatal period, preterm babies are at a higher risk of serious illness or death.

• #96 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth. Infants born at earlier gestational ages, especially 32 0/7 weeks, have the highest mortality and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics. Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority, can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact.

• #97 The epidemiology of preterm labor – a global perspective

  https://www.degruyter.com/document/doi/10.1515/JPM.2005.053/html?lang=en

  The major burden of preterm birth is in the developing world, where much of the death and morbidity is secondary to infectious diseases such as malaria, HIV, tuberculosis and intestinal parasites. […] Interventions to prevent preterm birth should predominantly be aimed at the prevention and treatment of infectious disease, and the improvement of maternal nutrition. Without this, medical intervention tends to increase the rate of preterm birth without corresponding improvement in outcomes.

• #98 The epidemiology of preterm labor – a global perspective

  https://www.degruyter.com/document/doi/10.1515/JPM.2005.053/html?lang=en

  The major burden of preterm birth is in the developing world, where much of the death and morbidity is secondary to infectious diseases such as malaria, HIV, tuberculosis and intestinal parasites. […] Interventions to prevent preterm birth should predominantly be aimed at the prevention and treatment of infectious disease, and the improvement of maternal nutrition. Without this, medical intervention tends to increase the rate of preterm birth without corresponding improvement in outcomes.

• #99 mmnwa.com, Preterm Birth Surveillance and Prevention Program

  https://www.mfmnwa.com/preterm-birth-prevention

  Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. In the United States, approximately 12% (13.1% in the state of Arkansas) of all live births occur before term (37 weeks), and preterm labor preceded approximately 50% of these preterm births. […] One way to combat the complications of a premature delivery is early recognition of those pregnancies at highest risk for preterm delivery. […] We utilize innovative cervical length surveillance protocols, along with periodic fetal fibronectin screening, to help identify those women at risk for preterm labor.

• #100 mmnwa.com, Preterm Birth Surveillance and Prevention Program

  https://www.mfmnwa.com/preterm-birth-prevention

  Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. In the United States, approximately 12% (13.1% in the state of Arkansas) of all live births occur before term (37 weeks), and preterm labor preceded approximately 50% of these preterm births. […] One way to combat the complications of a premature delivery is early recognition of those pregnancies at highest risk for preterm delivery. […] We utilize innovative cervical length surveillance protocols, along with periodic fetal fibronectin screening, to help identify those women at risk for preterm labor.

• #101 Epidemiology of late and moderate preterm birth

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4544710/

  Increases in the singleton preterm birth rate since 1990 have been almost entirely due to infants born late preterm. During 1990-2006, the late preterm birth rate for singleton births increased 20.9%, from 6.7% to 8.1%. […] Although the reasons for the increasing rates of moderate preterm and late preterm birth during the last two decades are not well understood, several theories have been postulated. These include improved risk assessment and timing for maternal and fetal disorders, more elective inductions and caesarean sections to reduce adverse fetal outcomes, increasing maternal age (35 years), and increasing rates of multiple gestations. […] Concern about the practice of elective induction or caesarean delivery without medical indication prompted the March of Dimes to launch a national campaign, Healthy Babies are Worth the Wait, to raise awareness among patients and providers on the importance of preventing non-indicated intervention. […] Late preterm birth accounts for the vast majority of preterm births in the USA and for the rise in the national preterm birth rate over the past two decades. Late and moderate preterm infants are both physiologically and developmentally immature and have higher risks for morbidity and mortality compared with infants born at term.

• #102 The epidemiology of preterm birth. – NeL.edu

  https://www.nel.edu/the-epidemiology-of-preterm-birth-2025/

  Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. […] The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. […] Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. […] Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described.

• #103 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  This is a specialist clinic which offers monitoring and treatment to pregnant women and people who are at higher risk of spontaneous early birth between 24 and 34 weeks of pregnancy (premature or preterm birth) or a late pregnancy loss (miscarriage) between 14 and 24 weeks of pregnancy. […] For high risk factors you should be offered an appointment in the preterm surveillance clinic at 12 weeks of pregnancy and for intermediate factors you should be offered one between 16 and 20 weeks. […] Its aim is to reduce your chance of early birth or late pregnancy loss. […] We look at your previous history and the results of the additional tests offered to you in the clinic to find out if you are at high risk of premature labour and whether you are likely to benefit from treatment or intervention.

• #104 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  This is a specialist clinic which offers monitoring and treatment to pregnant women and people who are at higher risk of spontaneous early birth between 24 and 34 weeks of pregnancy (premature or preterm birth) or a late pregnancy loss (miscarriage) between 14 and 24 weeks of pregnancy. […] For high risk factors you should be offered an appointment in the preterm surveillance clinic at 12 weeks of pregnancy and for intermediate factors you should be offered one between 16 and 20 weeks. […] Its aim is to reduce your chance of early birth or late pregnancy loss. […] We look at your previous history and the results of the additional tests offered to you in the clinic to find out if you are at high risk of premature labour and whether you are likely to benefit from treatment or intervention.

• #105 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  This is a specialist clinic which offers monitoring and treatment to pregnant women and people who are at higher risk of spontaneous early birth between 24 and 34 weeks of pregnancy (premature or preterm birth) or a late pregnancy loss (miscarriage) between 14 and 24 weeks of pregnancy. […] For high risk factors you should be offered an appointment in the preterm surveillance clinic at 12 weeks of pregnancy and for intermediate factors you should be offered one between 16 and 20 weeks. […] Its aim is to reduce your chance of early birth or late pregnancy loss. […] We look at your previous history and the results of the additional tests offered to you in the clinic to find out if you are at high risk of premature labour and whether you are likely to benefit from treatment or intervention.

• #106 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  If the results of the monitoring up until you are 24 weeks pregnant suggest that you are no longer at high risk of having your baby before 34 weeks, we will discharge you from the clinic. […] If you are among the small number of pregnant women and people who remain at high risk, we may continue to monitor you up to 32 weeks of pregnancy. […] There are several treatments which we may offer you up to 24 weeks of pregnancy. […] If you are at high risk after 24 weeks of pregnancy, we may offer steroid injections to help your baby’s lungs develop.

• #107 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  If the results of the monitoring up until you are 24 weeks pregnant suggest that you are no longer at high risk of having your baby before 34 weeks, we will discharge you from the clinic. […] If you are among the small number of pregnant women and people who remain at high risk, we may continue to monitor you up to 32 weeks of pregnancy. […] There are several treatments which we may offer you up to 24 weeks of pregnancy. […] If you are at high risk after 24 weeks of pregnancy, we may offer steroid injections to help your baby’s lungs develop.

• #108 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  If the results of the monitoring up until you are 24 weeks pregnant suggest that you are no longer at high risk of having your baby before 34 weeks, we will discharge you from the clinic. […] If you are among the small number of pregnant women and people who remain at high risk, we may continue to monitor you up to 32 weeks of pregnancy. […] There are several treatments which we may offer you up to 24 weeks of pregnancy. […] If you are at high risk after 24 weeks of pregnancy, we may offer steroid injections to help your baby’s lungs develop.

• #109 Preterm Surveillance Clinic | CUH

  https://www.cuh.nhs.uk/patient-information/preterm-surveillance-clinic-/

  If the results of the monitoring up until you are 24 weeks pregnant suggest that you are no longer at high risk of having your baby before 34 weeks, we will discharge you from the clinic. […] If you are among the small number of pregnant women and people who remain at high risk, we may continue to monitor you up to 32 weeks of pregnancy. […] There are several treatments which we may offer you up to 24 weeks of pregnancy. […] If you are at high risk after 24 weeks of pregnancy, we may offer steroid injections to help your baby’s lungs develop.

• #110 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #111 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #112 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #113 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #114 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #115 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #116 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #117 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

• #118 IMPART IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (including a realist literature scope)

  https://fundingawards.nihr.ac.uk/award/NIHR300484

  In the UK, 1 in 13 babies are born early (before a woman reaches 37 weeks of pregnancy) – otherwise known as 'preterm’. This means that around 60,000 babies are born preterm every year. Many preterm babies do not survive. If they do survive, they often have long-term health problems. Because of these poor health outcomes, the Department of Health plans to reduce the preterm birth rate. This would also help the NHS save money as preterm birth currently costs the NHS one billion pounds a year. Currently, women who are at risk of having a preterm birth receive different care depending on which hospital they receive treatment at. Some women are offered specialist care in a preterm birth prevention clinic, but many women do not receive any specialist care. At present, only 33 hospitals have a preterm birth prevention clinic out of 187 hospitals offering maternity care across the UK. NHS England has recently published some guidance on how to reduce preterm birth and help standardise care across the UK. This means that all women will receive the same care, even if they are at different hospitals. The new guidance has developed a pathway called the Preterm Birth Surveillance Pathway (PBP). This pathway says that midwives should assess every pregnant woman for her risk of having a preterm birth. This assessment will involve asking a woman questions about her medical history and deciding whether she is at high, intermediate or low risk of a preterm birth. If the midwife assesses the woman as being at high or intermediate risk of having her baby early, then they should refer her to a special preterm birth prevention clinic. Preterm birth prevention clinics are clinics where specialist doctors and midwives can offer the woman additional tests (such as scans and swab tests) alongside the normal care she receives when she is pregnant. These additional tests can help doctors and midwives decide which women may need further help, such as being admitted to hospital, to help stop her having her baby early. Now that this new guidance has been published, all hospitals are expected to follow the PBP for pregnant women at risk of having their baby early by April 2020. This will be a big change for many hospitals. This is the first-time guidance has recommended a PBP so it has never been reviewed or evaluated before. This study aims to research how, why, for whom, to what extent and in what contexts the Preterm Birth Surveillance Pathway is implemented through a realist evaluation (including a realist literature scope). A realist evaluation is a study design which would consider how the PBP may work differently in different hospitals. Instead of just asking 'what works?’, realist evaluation asks 'what works, for whom, in what circumstances?’. The data for the realist evaluation will be collected through mixed methods (interviews with women and staff, observing staff, looking at hospital guidelines and documentation, and analysing routinely collected hospital and admin data). This study will focus on three different hospitals to find out what happens in practice when hospitals start to use the PBP, explore what factors help or do not help implementation, and develop theories on how implementation of the pathway can be improved. This will lead to producing a set of recommendations for implementing the pathway in different hospitals so that it is taken up effectively across England.

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