Effectiveness of the Preterm Labor Prevention Program for High-Risk Pregnant Women: A Randomized Controlled Trial

Abstract

Preterm labor significantly impacts premature birth, influencing infant development and health outcomes. This randomized controlled trial aimed to develop and test the effectiveness of the Preterm Labor Prevention Program on primary outcomes (knowledge, attitudes, self-care practices) and secondary outcomes (preterm labor, preterm birth rates). Sixty-six high-risk participants aged 15-49 attending antenatal care clinics in Northeastern Thailand were selected using multi-stage random sampling. They were randomly assigned to either the experimental group (n = 32) receiving the Preterm Labor Prevention Program in addition to routine care or the control group (n = 34) receiving routine care. Data collection employed questionnaires on knowledge, attitude, self-care practice, preterm labor, and preterm birth rates. Data were analyzed using one-way repeated measures ANOVA for knowledge, attitudes, and self-care practice scores across three-time points at baseline before the intervention, immediately and four weeks after program completion, and chi-square tests for comparing preterm labor and premature birth rates across groups. Results indicated that the mean score of knowledge, attitude, and self-care practice in the experiment group was significantly increased over time immediately and four weeks after program completion and significantly higher than that of the control group at both time points. Furthermore, the incidence of preterm labor and the preterm birth rate in the experiment group were 6.25% and 3.10%, respectively. However, the incidence of preterm labor and the preterm birth rate in the control group were equal at 20.60%. Nurses and midwives can apply this program to increase knowledge, more positive attitudes, and practice to reduce preterm labor and preterm birth in high-risk pregnancies, but first, testing of the program is required with an increased number of participants.