Impact of antenatal lifestyle education on reducing preterm birth: A
retrospective cohort study
Abstract
Objective Investigate the effect of an antenatal lifestyle education
seminar on reducing preterm birth, and whether education timing modifies
outcomes among women with different characteristics. Design
Retrospective cohort study Setting A metropolitan hospital in Beijing,
China Population A total of 3008 singleton livebirths Methods Extracted
data from deidentified electronic medical records were analyzed. Odds
ratios (ORs) for preterm birth according to antenatal education
attendance using stepwise binary logistic regression stratified by
different maternal characteristics was conducted. Outcome measure
Preterm birth (gestational age <37+0 weeks) Results Overall
prevalence of preterm birth was 8.7%, but higher for women who did not
attend the antenatal seminar (11.5%). Risk of preterm birth for first
trimester attendees decreased by 53% ([OR] 0.47, 95% CI
0.35-0.64), and 41% for later attendees ([OR] 0.59, 95% CI
0.41-0.86). Estimates persisted after adjusting pre-existing and
gestational covariates. In subgroup analysis, young or nulliparous women
who attended later than first trimester were at decreased risk. For
women aged ≥35 years, multiparous, who had a previous caesarean
section/myomectomy, the risk of preterm birth was reduced among first
trimester attendees, but no longer significant after adjusting for
pre-existing and gestational covariates (p > 0.05). Timing
of the seminar was not significant for women received assisted
reproductive technologies. Conclusions Offering an antenatal lifestyle
education seminar was associated with lower preterm birth risk and was
modified by education timing and women’s characteristics. Results can
inform the development of tailored preterm birth prevention strategies.
Keywords Antenatal education, lifestyle factors, preterm birth,
intervention timing, health promotion.