Prevention and management of preterm birth in South London
5 Oct 2018

Prevention and management of preterm birth in South London

Published Date: 5 Oct 2018

CLAHRC South London's maternity and women’s health theme is undertaking research to improve the prevention and management of preterm birth by assessing the feasibility and cost-effectiveness of a new model of care, which combines continuity of midwife care with a specialist preterm birth clinic. As part of this work, the research team have gathered evidence on the benefits of continuity of care models (see Annual Report 2015-16). A Cochrane review (April 2016) led by Professor Jane Sandall showed that women who used these models were 19% less likely to miscarry, 16% less likely to lose their baby overall, and 24% less likely to have a premature baby. This work has had significant impact on health policy. Nationally, it informed the Department of Health and Social Care’s plans announced in March 2018 to introduce continuity of midwife care for the majority of women in England by 2021. The research was also cited by the Department’s strategy ‘Safer maternity care’ (December 2017). Internationally, the research was cited in the World Health Organization’s (WHO) antenatal guidance (2016) and intrapartum care guidance (2018).

The maternity and women’s health theme is assessing the impact of the quality of care, feasibility and cost-effectiveness of a new model of care. The model combines continuity of care for women at high risk of preterm birth with a specialist preterm birth clinic – the POPPIE study.  To date 332 women have been recruited and recruitment will be complete by October 2018. Data will be reported and analysed by Dec 2018.

NIHR CLAHRC South London funded the primary investigator’s contribution to the Cochrane review and the POPPIE trial, the researcher’s time, and research costs, expert advice on implementation design and analysis and health economic expert advice.

Contribution of CLAHRC South London

NIHR CLAHRC South London funded the primary investigator’s contribution to the Cochrane review and the POPPIE trial, the researcher’s time, and research costs, expert advice on implementation design and analysis and health economic expert advice.

What happened next?

Lewisham NHS Trust plans to continue supporting the continuity of care model after the POPPIE study has ended.

Professor Jane Sandall CBE is a member of an expert group advising NHS England on continuity of care implementation and was commissioned by NHS England to develop a measurement and evaluation framework to support Implementing Better Births: Continuity of Carer (2017). She also led a rapid evidence review for NHSE to inform the National Quality Board improvement resource for maternity services, Safe, sustainable and productive staffing: An improvement resource for maternity services June 2017.