A significant reduction in premature births in Western Australia shows prevention efforts should be targeted at all pregnant women, not just those with risk factors, researchers say.
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Key findings from the first three years of WA's preterm birth prevention program were published on Friday in leading medical journal PLOS One.
An eight per cent reduction was recorded within the first year of the program, launched in 2014 by Women & Infants Research Foundation chief scientific director John Newnham.
But while the state's largest maternity hospital continued to record lower numbers of preterm births, initial improvements were not sustained elsewhere.
The study found that efforts to educate medical practitioners about interventions to prevent premature births, such as identifying a shortened cervix and avoiding unnecessary cesarean sections, had dropped off after the first year.
Doctors working in non-tertiary hospitals may have been more likely to respond to risk factors by inducing early births in the hopes of preventing stillbirth, the authors suggested.
The greatest reduction in preterm birth rates at King Edward was in pregnancies classed as low-risk.
Professor Newnham, who was named Senior Australian of the Year for 2020, said this indicated interventions needed to be aimed at all pregnant women, not just those with risk factors.
"It's taken us more than 30 years to find out how we can safely prevent preterm birth and now - armed with detailed analysis to inform our approach moving forward - we can work on reducing rates of early birth even further," Prof Newnham said.
"There is no better place in the world to have a baby than in Australia and we want to keep it that way."
Educational programs needed to maintain a high level of intensity given the constant turnover of new mothers, he added.
There was also significant success in the Kimberley, a region with one of the nation's highest rates of preterm births.
A "dramatic" decline was recorded after progesterone treatment was provided free of charge and a midwifery continuity of care program was adopted.
Nearly 3000 babies are born preterm - after 20 weeks gestation but before 37 weeks - in WA each year.
It is the greatest cause of death and disability in children under five years old in the developed world and is twice as likely among Aboriginal Australians as non-indigenous people.
Australian Associated Press
