[Preconceptional health promotion and counselling pregnant women in choosing their obstetric clinic as further tools in the reduction of preterm deliveries].
BACKGROUND
More than 100 000 women have already participated in the given BabyCare programme. It is highly accepted by pregnant woman, gynaecologists as well as the health insurance companies co-operating. Evaluation of the birth outcomes is done annually in comparison with a given perinatal data base. We look for further tools to reduce preterm deliveries.


METHODS
Birth outcome is analysed based on a sample of 3 345 births documented by the gynaecologist controlled for age, parity, multiple gestation and education level. The preventive potentials of preconceptional interventions are exemplified and the given problems in the choice of obstetric clinics are summarized.


RESULTS
Women participating in the BabyCare programme have a rate of preterm birth which is 20 to 25 % lower than in the control group. Additional preconceptional health promotion can reduce pregravid risk factors and provides many opportunities for preventive measures, which may reduce the incidence of severe complications substantially. Targeted counselling the choice of a clinic will additionally provide support for women with high risk pregnancies and may lead to a further reduction of complications or rather to a better management of incident complications.


CONCLUSIONS
Health and nutritional counselling in early pregnancy by the BabyCare programme leads to a stable, significant, effective and efficient reduction of preterm births. The additional preconceptional and antepartal measures may contribute to a further reduction of complications.
Dudenhausen
J W
JW
Klinik für Geburtsmedizin Charité, Campus Virchow Klinikum und Campus Benjamin Franklin, Berlin. joachim.dudenhausen@charite.de
Friese
K
K
Kirschner
W
W
D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000517:prevention & control*; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000379:methods / Q000706:statistics & numerical data*; D016742:Preconception Care / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control; D015397:Program Evaluation