USF’s Professor John Newnham recently spearheaded a revolutionary study. This research has been pivotal in decreasing preterm and early term birth rates nationwide in Australia. That research compared the health outcomes of two million births. Specifically, it adopted seven clinical strategies to reduce non-medically indicated early deliveries to zero. As a result, this initiative has seen a dramatic 7 to 10 percent reductions in both preterm and early term births. Because of their work, we’re now seeing 4,000 fewer babies born too soon each year.
Preterm birth occurs when a baby is born before 37 weeks of gestation. It remains one of the top contributors to neonatal death and disabilities worldwide. At the same time, early term births, those between 37 and 39 weeks, have been demonstrated to have risks for the newborn. Given the risk to infant health, our study led by Professor Newnham underscores the need to avoid any non-medically justified deliveries prior to 39 weeks.
The Phased Approach to Reducing Early Births
Our multimodal six-year study played out in two very different acts. The first phase focused on the goal of reducing preterm births. In doing so, we surpassed that goal with an 8 percent reduction — 1,342 fewer cases annually. The second phase concentrated on reducing early term births and was incredibly successful. Over that short, 16-month period, it still managed a laudable 10 percent reduction, affecting approximately 5,300 more cases.
Professor Newnham highlighted the significance of this structured approach: “We set out to form a national program to lower Australia’s rate of pre-term birth, funded by the federal government, but with support all the way down through to individual hospitals, and we were successful.” This initiative marks a historic achievement, as he notes that “no-one in the world has ever been able to lower their rate of pre-term birth across the nation.”
Clinical Strategies Implemented
Across each of these areas, the study aimed to develop seven concrete clinical strategies. One of them is to regularly check the length of the cervix during regular morphology scans at 20-22 weeks. Dr. Nisha Khot, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, pointed to an exciting development. These practices are already changing the way obstetric care is delivered across Australia.
Now, every time we do a morphology scan at 20 to 22 weeks, we look to see how long the cervix is. It’s now standard practice all over the country,” said Dr. Khot. She said she was hopeful about the study’s potential results. She added, “Doctors are going to really get a… …and I’m already seeing doctors change their practices from this.
Medical conditions, such as high blood pressure, sometimes need deliveries to happen earlier, Professor Newham pointed out. He underscored the need for healthcare providers to stop scheduling births prior to 39 weeks unless there’s no other option. “There are medical reasons such as high blood pressure, but in the absence of those reasons, babies should be left where they belong until at least 39 weeks,” he explained.
Real-Life Impact on Families
The impact of this study goes far beyond the stately percentage reductions. It’s deeply felt by the families that are touched by premature births. She shared her harrowing experience of the postpartum period soon after welcoming her daughter Ava. Ava was delivered through emergency caesarean at just 25 weeks due to my extreme life-threatening pre-eclampsia. Ava ended up spending a traumatic 101 days in the neonatal intensive care unit.
Phillips expressed satisfaction at the initiative’s ripple effects. He said, “We did it — we got him all the way to 37 weeks … it was largely due to the information that has emerged from this world-first program. She underscored her gratitude for the collaborative efforts of those involved in the project: “It’s genuinely life-saving work and we are so lucky to have these teams of people working together not only on the research side but with hospitals all over Australia to ensure that the life-saving work that they are coming up with is being enacted in real life.”
Dr. Khot congratulated the trial’s success. He cautioned that much work lies in stopping the risk of early births before 32 weeks of gestation. She stressed that hospitals should never plan to deliver babies before 39 weeks. In her view, this is only appropriate if there’s a darn good reason.
