title: A preterm birth prevention project in Nova Scotia, Canada.
abstract: OBJECTIVE
  The Halifax County Preterm Birth Prevention Project was designed to evaluate the effectiveness of a population-based preterm birth (PTB) prevention program in Nova Scotia from January 1995 through June 1997 (n = 10,326).
  
  
  METHODS
  Preterm birth rates, adjusted for risk status and maternal age, were evaluated over time in Halifax County and compared to non-Halifax County parturients in Nova Scotia. Physician participation was evaluated by means of a mailed survey.
  
  
  RESULTS
  There was no appreciable change in the overall (<37 weeks) or early (<34 weeks) PTB rates within or outside Halifax County during the intervention period compared to the preintervention period. Although not significant, the very (<30 weeks) PTB rate in Halifax County decreased by 40% from 0.53 to 0.32%, while outside Halifax County it remained stable (0.43-0.42%). There was a statistically significant decrease in early and very PTB associated with spontaneous labour, as well as an apparent shift in the timing of delivery from very preterm to preterm (> or =30 weeks). Participation among responding physicians was greater for high-risk than low-risk women, but full compliance with project recommendations was low.
  
  
  CONCLUSIONS
  The overall ineffectiveness of the Halifax County Preterm Birth Prevention Project may reflect the reluctance of practitioners to fully incorporate the recommended prevention strategies into their practice. However, such interventions may reduce the risk of spontaneous early preterm birth.
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, Nova Scotia, Canada. anthony.armson@iwk.nshealth.ca
authors.forename: B A
authors.initials: BA
authors.lastname: Armson
authors.forename: L
authors.initials: L
authors.lastname: Dodds
authors.forename: C
authors.initials: C
authors.lastname: Cervin
authors.forename: S
authors.initials: S
authors.lastname: Christie-Haliburton
authors.forename: K
authors.initials: K
authors.lastname: Rinaldo
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D009674:Nova Scotia; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D010353:Patient Education as Topic; D010865:Pilot Projects; D011247:Pregnancy; D011295:Prenatal Care; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome