(HealthDay News) – For 39 countries with very high human development index (VHHDI), implementation of five interventions could reduce preterm delivery rates by 5% by 2015, according to a study published online Nov. 16 in The Lancet.
Hannah H. Chang, MD, of the Boston Consulting Group, and colleagues examined the trends in preterm birth and estimated the potential reduction for 39 countries with VHHDI, if evidence-based preventive interventions were widely implemented.
The researchers found that, from 2010, even if all countries with VHHDI achieved the annual preterm birth reductions of the best performers for 1990–2010 (Estonia and Croatia), 2000–2010 (Sweden and the Netherlands), or 2005–2010 (Lithuania and Estonia), the relative reduction would be <5% by 2015. Based on analysis of increasing preterm birth in 1989–2004 in the United States, drivers included non-medically indicated labor induction and cesarean delivery as well as assisted reproductive technologies, with half the change unexplained. Five interventions modeling at high coverage predicted a 5% relative reduction in preterm birth for all 39 countries with VHHDI: smoking cessation; decreasing multiple embryo transfers during assisted reproduction; cervical cerclage; progesterone supplementation; and reduction of non-medically indicated labor induction or delivery by cesarean.
“We recommend a conservative target of a relative reduction in preterm birth rates of 5% by 2015,” the authors write. “Our findings highlight the urgent need for research into underlying mechanisms of preterm births, and development of innovative interventions.”