Evaluation of antenatal care quality for preterm birth prevention using an auditable scoring system: A retrospective, descriptive, longitudinal study in Sydney, Australia.

Preterm birth continues to be one of the most significant contributors to perinatal death. This study aims to evaluate the quality of antenatal care provided to women delivering preterm. This was a retrospective, descriptive, longitudinal review of all women who had antenatal care within a single Australian tertiary hospital and delivered spontaneously between 24 and 37 weeks of gestation, using an auditable scoring system assessing potential interventions for prevention of preterm birth. The review was limited to singleton pregnancies without fetal abnormalities delivering between January 2013 and April 2015. The audit tool was developed by reference to established 'best practice' guidance for prediction and prevention of preterm birth based on Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines and published literature. Different pathways were assessed for women deemed either low- or high-risk at the outset of antenatal care. A series of 161 pregnancies that delivered preterm (between 24 and 37 weeks' gestation) were reviewed. The quality of antenatal care was scored 'good' in 42.9% and 50% of high-risk and low-risk women, respectively. Care was scored 'adequate', with room for improvement in 51.4% and 45.2% of the two corresponding groups. The main deficiencies in care were recorded evidence of assessment of cervical length (absent in 35% of cases) and failure to screen for bacterial vaginosis in high-risk women. Auditing antenatal care for prevention of preterm birth allows identification of suboptimal practice allowing service improvement and potential intervention for preterm birth prevention.

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© 2024 Rawashdeh H. et al.

Déclaration de conflit d'intérêts

The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. J. Hyett reports that in the past 36 months NHMRC funded grant with payments to the University of Sydney, that he is the CI on the Espresso study, a randomized controlled trial for prevention of preeclampsia funded by Australian NHMRC and that the study had no impact on this work. Furthermore, he declares that in the past 36 months payments were made to him as he has acted as a consultant to Menarini for the development of cell based NIPT (not related to this work). Also, he declares that in the past 36 months he has given a lecture for Besins Pharmaceuticals on the use of progesterone for the prevention of preterm birth that was not paid and not related to this work. In addition, he reports that in the past 36 months, he has been a trustee of the Fetal Medicine Foundation, a charity based in the UK.