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Background: Reducing rates of preterm birth (PTB) remains a significant challenge. The Northern Territory (NT) records some of the highest rates of PTB in the country, especially in First Nations women. In 2014, a Western Australian (WA) preterm birth prevention initiative involved the implementation of seven key initiatives. One of these was routine mid-trimester cervical length measurement. The initiative successfully reduced PTB rates following its first year of implementation. This was the first successful reduction in PTB, including the earlier gestational ages, across a population.

Aims: To assess the uptake of routine cervical length measurement in the Top End of the NT after the success of the WA PTB prevention initiative and assess if treatment of a short cervix improved PTB rates.

Methods: A retrospective cohort study of all women who received antenatal care and delivered their baby at the NT's only tertiary hospital was performed. Mid-trimester ultrasound scan data were collected from two separate time windows, before and after the implementation of the WA intervention. Treatments and gestational age at birth were recorded.

Results: Adoption of routine screening of cervical length measurement at mid-trimester ultrasound in the NT was successful, increasing from 4 to 88%. Detection rates of short cervix doubled. However, there was no difference to PTB rates despite targeted management.

Conclusion: PTB remains a significant challenge in the NT, especially for First Nations women who are found to have a short cervix more commonly than non-Indigenous women in the Top End.

(© 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Titel:	Short cervix and preterm birth in the top end.
Autor/in / Beteiligte Person:	Brown, K ; Lam, CKM ; Binks, M
Link:	Full Text Finder (Volltext)
Zeitschrift:	The Australian & New Zealand journal of obstetrics & gynaecology, Jg. 63 (2023-08-01), Heft 4, S. 521-526
Veröffentlichung:	Melbourne : Wiley-Blackwell ; <i>Original Publication</i>: Melbourne : Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2023
Medientyp:	academicJournal
ISSN:	1479-828X (electronic)
DOI:	10.1111/ajo.13676
Schlagwort:	Pregnancy Female Infant, Newborn Humans Cervix Uteri diagnostic imaging Retrospective Studies Australia Cervical Length Measurement Premature Birth epidemiology Premature Birth prevention & control Cerclage, Cervical
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Aust N Z J Obstet Gynaecol] 2023 Aug; Vol. 63 (4), pp. 521-526. <i>Date of Electronic Publication: </i>2023 Apr 04. MeSH Terms: Premature Birth* / epidemiology ; Premature Birth* / prevention & control ; Cerclage, Cervical* ; Pregnancy ; Female ; Infant, Newborn ; Humans ; Cervix Uteri / diagnostic imaging ; Retrospective Studies ; Australia ; Cervical Length Measurement References: AIHW, Australia's mothers and babies, AIHW, Editor. 2022: Web report. ; Bhat SLL, O'Neil L, Jennings B. In: Health N, ed.. Mothers and babies 2019: Northern Territory Midwives' Collection. Northern Territory: Darwin, 2021. ; Newnham JP, White SW, Meharry S, Lee HS, Pedretti MK, Arrese CA et al. Reducing preterm birth by a statewide multifaceted program: An implementation study. Am J Obstet Gynecol 2017; 216(5): 434-442. ; Berman YE, Newnham JP, White SW, Brown K, Doherty DA. The Western Australian preterm birth prevention initiative: A whole of state singleton pregnancy cohort study showing the need to embrace alternative models of care for aboriginal women. BMC Pregnancy Childbirth 2023; 23(1): 7. ; Society for Maternal-Fetal Medicine. Electronic address, p.s.o et al. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol 2016; 215(3): B2-B7. ; Romero R, Conde-Agudelo A, da Fonseca E, O'Brien JM, Cetingoz E, Creasy GW et al. Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: A meta-analysis of individual patient data. Am J Obstet Gynecol 2018; 218(2): 161-180. ; Berghella V, Saccone G. Cervical assessment by ultrasound for preventing preterm delivery. Cochrane Database Syst Rev 2019; 9(9): CD007235. ; RANZCOG. Measurement of cervical length for prediction of preterm birth. Best Practice Statement 2021; C-Obs 27. ; TGA. Oripro Consumer Medicine Information: Canberra, Australia, Theraputic Goods Administration, 2019. ; McInerney C, Ibiebele I, Ford JB, Randall D, Morris JM, Meharg D et al. Benefits of not smoking during pregnancy for Australian aboriginal and Torres Strait islander women and their babies: A retrospective cohort study using linked data. BMJ Open 2019; 9(11): e032763. ; Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371(9606): 75-84. ; Payne MS, Newnham JP, Doherty DA, Furfaro LL, Pendal NL, Loh DE et al. A specific bacterial DNA signature in the vagina of Australian women in midpregnancy predicts high risk of spontaneous preterm birth (the Predict1000 study). Am J Obstet Gynecol 2021; 224(2): 206 e1-206 e23. ; Brown K, Unger HW, Peel M, Doherty DA, Lee M, Kujawa A et al. A Project to Validate the GLU Test for Preterm Birth Prediction in First Nations Women. Microbiology Australia, 2022;43(3), 130-134. ; AIHW. In: A.I.o.H.a Welfare, ed. Incidence of Gestational Diabetes in Australia, 2019; Canberra:AIHW. Contributed Indexing: Keywords: Northern Territory; cervical cerclage; cervical length measurement; preterm birth; progesterone; ultrasound Entry Date(s): Date Created: 20230405 Date Completed: 20230810 Latest Revision: 20230810 Update Code: 20231215

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Short cervix and preterm birth in the top end.