Evaluation of a community-wide preterm birth prevention program.

VOLUME 92, NO. 5 Although there has been progress in reducing the impact of most disease processes that contribute to infant morbidity and mortality, there has been no significant reduction in the incidence of preterm birth in the past 25 years. Preterm birth, defined as any delivery that occurs before 37 weeks gestation, remains the leading cause of neonatal morbidity and mortality, representing one of the most important perinatal health problems in Canada. Some researchers believe that a communitywide approach to intervention is a promising avenue for the reduction of the morbidity and mortality due to preterm birth and many of these interventions have been recently implemented in communities across Ontario. However, few studies exist to evaluate their effectiveness. The objective of this study was to evaluate the implementation and outcomes of the community-wide preterm birth prevention program Reach, React, Respond. The program consisted of visits by public health nurses to all prenatal caregivers to emphasize the need to teach all women the signs of preterm labour and the appropriate response (Implementation). The intervention involved caregivers teaching women about these signs and symptoms (Reach) and the action women should take if they experience them (React). Caregivers were also provided with evidence-based guidelines for the treatment of women in preterm labour with tocolytic and corticosteroid drugs (Respond).