SCREENING TO PREVENT PRE-TERM BIRTH

Screening to prevent pre-term birth

Background

Pre-term birth is defined as delivery at less than 37 completed weeks' of gestation. Before 34 weeks gestation pre-term birth accounts for three-quarters of neonatal mortality and one half of neurological impairment in children. In response to a special call for proposals by the HTA Programme this project aimed to evaluate the effectiveness and cost-effectiveness of interventions to screen for and prevent pre-term birth.

Findings

An effective, affordable and safe intervention applied to all mothers without preceding testing is likely to be the most cost-effective approach to reducing spontaneous preterm births among asymptomatic antenatal women in early pregnancy for primary prevention. For secondary prevention among women symptomatic of threatened preterm labour in later pregnancy, a management strategy based on results of testing is likely to be more cost-effective.

Conducted by: H Honest¹, CA Forbes², KH Durée², G Norman², SB Duffy², A Tsourapas³, TE Roberts³, PM Barton³, SM Jowett³, CJ Hyde⁴, KS Khan¹

1. Birmingham Women's Hospital and Department of Obstetrics and Gynaecology, University of Birmingham; 2. Centre for Reviews and Dissemination; 3. Health Economics Facility, University of Birmingham; 4. ARIF and HTA West Midlands Group, Department of Public Health and Epidemiology, University of Birmingham

Further details

Project page on HTA Programme website

Publications

Honest H, Forbes CA, Durée KH, Norman G, Tsourapas A, Roberts TE, Hyde CJ, Duffy S, Khan KS. Screening to prevent pre-term birth - systematic reviews of accuracy and effectiveness literature with economic modeling. Health Technol Assess. 2009; 13(43): 1-334

Funding

Commissioned by the HTA Programme on behalf of the National Screening Committee