Activity restriction and preterm birth prevention

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emily E. Nuss ◽  
Anthony C. Sciscione
Author(s):  
Ghamar Bitar ◽  
Anthony Sciscione

Objective Despite lack of evidence to support efficacy, activity restriction is one of the most commonly prescribed interventions used for the prevention of preterm birth. We have a departmental policy against the use of activity restriction but many practitioners still prescribe it in an effort to prevent preterm birth. We sought to evaluate the rate and compliance of women who are prescribed activity restriction during pregnancy to prevent preterm birth. Study Design This was a single-site retrospective questionnaire study at a tertiary care, academic affiliated medical center. Women with a history of preterm delivery or short cervix were included. Once patients were identified, each patient was contacted and administered a questionnaire. We assessed the rates of activity restriction prescription and compliance. Secondary outcomes included details regarding activity restriction and treatment in pregnancy. Continuous variables were compared with t-test and categorical variables with Chi-square test. The value p < 0.05 was considered significant. Results Among the 52 women who responded to the questionnaire, 18 reported being placed on activity restriction by a physician, with 1 self-prescribing activity restriction, giving a rate of our primary outcome of 19 of 52 (36.5%). All women reported compliance with prescribed activity restriction (100%). Gestational age at delivery was not different in women placed on activity restriction. Conclusion This questionnaire suggests that approximately one in three high-risk women were placed on activity restriction during their pregnancy despite a departmental policy against its use. The 100% compliance rate in patients placed on activity restriction is a strong reminder of the impact prescribing patterns of physicians can have on patients. Key Points


2014 ◽  
Vol 57 (3) ◽  
pp. 616-627 ◽  
Author(s):  
SIOBHAN MCCARTY-SINGLETON ◽  
ANTHONY C. SCISCIONE

2010 ◽  
Vol 12 (2) ◽  
pp. 106-124 ◽  
Author(s):  
Judith A. Maloni

Preterm birth is the major maternal—child health issue across developed nations and the leading cause of perinatal mortality and morbidity. Of all deaths of infants <1year of age in the United States in 2005, 68.6% occurred in infants born prior to term. Although the preterm birth rate in European countries is 5-7%, the U.S. preterm birth rate is 12.7%, representing an increase of 9% since 2000. Antepartum bed rest/activity restriction (ABR/AR) has been a mainstay of treatment to prevent preterm birth for the past 30 years prescribed for nearly 1 million women in the United States annually, despite a lack of evidence for its effectiveness. In fact, there is increasing evidence that ABR causes several adverse physiologic and psychological side effects among women and their infants. Unfortunately, these findings have had little impact on clinical practice. This integrative review of literature provides a comprehensive analysis of the evidence for the practice of prescribing ABR and its physiologic, behavioral, and experiential side effects. It also presents a model to guide continuing research about the effects of maternal bed rest as well as evidence supporting the use of home care with bed rest, a different, safe, and feasible model of prenatal care for treating women with pregnancy complications used particularly in other countries. Finally, suggestions to improve the health of high-risk pregnant and postpartum women and their infants are provided.


2014 ◽  
Vol 210 (1) ◽  
pp. S360
Author(s):  
Justin Brandt ◽  
Stephanie Purisch ◽  
Sindhu Srinivas ◽  
Jamie Bastek

2008 ◽  
Vol 30 (4) ◽  
pp. 317-326 ◽  
Author(s):  
Ann E. Sprague ◽  
Beverley O’Brien ◽  
Christine Newburn-Cook ◽  
Maureen Heaman ◽  
Carl Nimrod

Author(s):  
Dua' Al-Maharma ◽  
Inaam Khalaf ◽  
Fathieh Abu-Moghli ◽  
Sajeda Alhamory

Activity restriction in hospital to prevent preterm birth (PTB) is widely used as the first step of treatment. It is associated with adverse physiological and psychological effects on maternal and fetal health that might persist years after birth. A sample of 10 pregnant women who were hospitalized for being at risk for PTB were purposively recruited to describe their lived experience via semi-structured in-depth interview. Five themes were identified, the maternal role establishment and suspending responsibilities, the women's perception of fear of uncertainty and finding support, dissatisfaction of care, the change of routine life and family relationships, and the cultural influence from the participants perspectives. Pregnant women with threat of PTB endure the physical and psychological suffering from being hospitalized to reach their ultimate goal of “having alive and healthy child via safe birth.” A nurse’s understanding of this experience is essential to provide a competent, compassionate and woman-centered care that can help women to cope and to establish maternal role. The study findings serve as a framework for improving services at health care facilities to be mother friendly to mitigate the negative effect of hospitalization during pregnancy on the women and their child health years after birth.


Ob Gyn News ◽  
2008 ◽  
Vol 43 (5) ◽  
pp. 1-4
Author(s):  
PATRICE WENDLING
Keyword(s):  

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