{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:24:06Z","timestamp":1790115846341,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Spontaneous preterm birth is a major cause of perinatal morbidity and mortality and has traditionally been viewed as an inevitable event affecting a small proportion of pregnancies. Clinical practice guidelines recommend measures to predict pregnancies at risk of spontaneous preterm birth and prophylactic treatments. We performed this study to assess adherence to current guidelines for prediction and prevention of spontaneous preterm birth and to evaluate the effectiveness of current predictive tools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Retrospective audit of all spontaneous preterm birth in singleton pregnancies preceded by spontaneous labor or preterm prelabor rupture of membranes less than 37\u2009weeks at an Australian metropolitan hospital from January 1, 2019, and December 31, 2020. Termination of pregnancy and fetal abnormalities were excluded. Electronic medical record data was collected for maternal demographic information, antenatal care and use of current predictive measures, use of prophylactic treatments, and pregnancy and newborn outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred sixty\u2010seven spontaneous preterm births were included, comprising 3.5% of all births over the study period. Seventy\u2010eight percent of these were in women defined as low\u2010risk for preterm birth. Screening for bacteriuria was performed in 59.1% and 65.9% of low\u2010 and high\u2010risk women, respectively. Cervical length measurement was performed in 65% and 72% of low\u2010 and high\u2010risk women; only 10.7% of low\u2010risk and 11.4% of high\u2010risk women with sPTB had a short cervix prior to 24<jats:sup>+6<\/jats:sup> weeks gestation. The mean gestational age at birth was 34<jats:sup>+0<\/jats:sup> and 35<jats:sup>+0<\/jats:sup> weeks for low\u2010 and high\u2010risk women (<jats:italic>p<\/jats:italic>\u2009=\u20090.38); the rate of perinatal death was 9.6% in low\u2010risk pregnancies and 4.2% in high\u2010risk pregnancies (<jats:italic>p<\/jats:italic>\u2009=\u20090.39).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adherence to clinical guideline recommendations for prediction and prevention of sPTB was suboptimal in this cohort. The majority of spontaneous preterm births occur in women without risk factors and most women with sPTB in this cohort were not identified as having a short cervix in the early second trimester; these preterm births are therefore not identified by current predictive tools. Preterm birth continues to be associated with an increased risk of perinatal death despite the use of current predictive and preventative measures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15079","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T10:34:46Z","timestamp":1740047686000},"page":"906-912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reframing spontaneous preterm birth as a preventable adverse outcome\u2014A clinical audit of a preventative toolbox"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4281-0357","authenticated-orcid":false,"given":"Aparna","family":"Ramachandran","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Institute for Women, Children and Their Families Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Department of Women and Babies Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darazel","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Neonatology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Gordon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Institute for Women, Children and Their Families Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Department of Neonatology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Hyett","sequence":"additional","affiliation":[{"name":"Sydney Institute for Women, Children and Their Families Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Department of Obstetrics and Gynaecology, School of Medicine Western Sydney University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00878-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-10-S1-S2"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2017.01.003"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1251816"},{"key":"e_1_2_12_7_1","volume-title":"Clinical Practice Guidelines: Pregnancy Care","author":"Australian Government Department of Health","year":"2020"},{"key":"e_1_2_12_8_1","unstructured":"National Institute for Clinical and Health Excellence (NICE).NG25 \u2010 Preterm labour and birth [Internet].2019.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK327571\/pdf\/Bookshelf_NBK327571.pdf"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00217-8"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17003"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14987"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.04.003"},{"key":"e_1_2_12_13_1","unstructured":"Australian College of Midwives.National Midwifery Guidelines for Consultation and Referral (4th edition) [Internet].2021[cited 2024 Jul 1].https:\/\/www.midwives.org.au\/common\/Uploaded%20files\/_ADMIN\u2010ACM\/National\u2010Midwifery\u2010Guidelines\u2010for\u2010Consultation\u2010and\u2010Referral\u20104th\u2010Edition\u2010(2021).pdf"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15514"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-05119-7"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12610"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12713"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.08.013"},{"key":"e_1_2_12_20_1","unstructured":"Australian Institute of Health and Welfare.Australia's mothers and babies 2019 [Internet]. 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