Authors
Schlembach D, Simeoni U, Nagy Bonnard L, Bernloehr A, Cetin I, Gente M, Grosek S, Johnston L, Jourdain G, Kainer, Ratnavel N, Rossi R, Roth-Kleiner M, Visser G
Authors
Schlembach D, Simeoni U, Nagy Bonnard L, Bernloehr A, Cetin I, Gente M, Grosek S, Johnston L, Jourdain G, Kainer, Ratnavel N, Rossi R, Roth-Kleiner M, Visser G
Healthcare professionals caring for women, perinatal units, hospitals, and health services
All (pregnant) women receive timely information and counselling about potential risk factors for and signs and symptoms of preterm birth and how to find appropriate healthcare advice. (see TEG Follow-up & continuing care)
Risk identification and education regarding the signs and symptoms of preterm birth are essential components of obstetric care. They should be a routine part of obstetric care, since counselling of women and their partners and early intervention may be effective in reducing the risk of preterm birth. Healthcare providers (be it a midwife, general practitioner or an obstetrician/gynaecologist) should be able to advise and appropriately triage patients at risk for preterm birth. (1–10)
Differentiation between low risk and high risk pregnancies is important to assess the best strategy of preventing preterm birth or managing women at risk. Specific standards of care should be applied to women with known risk factors for preterm birth. Early detection and provision of specialist care may reduce the incidence of preterm birth and the associated fetal/neonatal and maternal complications. (1–10). Although for the majority of preterm births the cause may be uncertain, there are specific risk constellations that women and healthcare professionals should be aware of.
Criteria/risk factors for preterm birth include pregnancy related factors, demographic and behavioural factors, underlying medical conditions of the mother and fetal conditions (detailed information see table at “description”). (1–10)
Short-term benefits
Long-term benefits
Component | Grading of evidence | Indicator of meeting the standard | |
For parents and family | |||
1. | (Pregnant) women are informed by healthcare professionals about risk factors and also symptoms and/or signs for impending pregnancy complications. (13,14,20–24) | A (High quality) B (High quality) |
Patient information sheet |
2. | Accurate communication (all essential information) is provided. (13,14) | A (High quality) B (High quality) |
Parent feedback |
For healthcare professionals | |||
3. | Training on the risks and signs of preterm birth and tools for assessment of risk for impending preterm birth is attended by all responsible healthcare professionals. (25–30) | A (High quality) B (High quality) |
Training documentation |
4. | Professional and empathic communication is provided. (13,14) | A (High quality) B (High quality) |
Healthcare professional feedback, parent feedback |
5. | Women at risk for very preterm birth are cared for exclusively in specialist centres. (31–33) | A (High quality) B (High quality) |
Audit report |
For perinatal unit | |||
6. | A unit guideline on procedures and algorithms for the management of threatened preterm birth and underlying conditions is available and regularly updated. (34) | A (High quality) B (High quality) |
Guideline |
7. | Women at risk for very preterm birth are referred and transferred to appropriate delivery clinic in a timely fashion. (31–33) | A (High quality) B (High quality) |
Audit report |
For hospital | |||
8. | Training on the risks and signs of preterm birth and tools for assessment of risk for impending preterm birth is ensured. | B (High quality) | Training documentation |
9. | Continuous quality improvement programme is in place. (35) | A (High quality) B (Moderate quality) |
Audit report |
For health service | |||
10. | A national guideline on procedures and algorithms for the management of threatened preterm birth and underlying conditions is available and regularly updated. | B (High quality) | Guideline |
11. | Regional networks for perinatal care are established. (36) | A (High quality) | Regional network |
12. | Risk reduction programmes are in place. | B (Moderate quality) | Audit report |
13. | An appropriate working environment for pregnant women is provided by employers. (37) | C (High quality) | Workplace legislation |
Further development | Grading of evidence | |
For parents and family | ||
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B (High quality) | |
For healthcare professionals | ||
N/A | ||
For perinatal unit | ||
N/A | ||
For hospital | ||
N/A | ||
For health service | ||
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B (Moderate quality) | |
Initial steps | |
For parents and family | |
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For healthcare professionals | |
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For perinatal unit | |
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For hospital | |
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For health service | |
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Risk factors for preterm birth (3–10)
Pregnancy related conditions
Fetal conditions
Underlying medical conditions
Demographic factors
Modifiable lifestyle risk factors
November 2018 / 1st edition / next revision: 2023
Recommended citation
EFCNI, Schlembach D, Simeoni U et al. European Standards of Care for Newborn Health: Information provision for women about the risk for preterm birth. 2018.