Shemesh A A, Dar E, Ben Ishai F, Yanai S, Yaffe H
Israel Ministry of Health, National Insurance Institute, Jerusalem.
Harefuah. 1991 Jan 1;120(1):1-5.
Programs for the prevention of premature births have been developed world-wide to reduce perinatal mortality and child morbidity and handicaps. The Beit Shemesh intervention program focused on locating and improving socio-economic conditions, in addition to medical-nursing aspects. Beit Shemesh (located 30 km SW of the nearest Jerusalem hospital; population 14,000; 350-400 births per year) was chosen because its rates for preterm delivery (36 weeks or less) and for low birthweight neonates were higher than the national rates, it was of low socio-economic status, and because of its well-developed and accessible local health services infrastructure. The main goals of the intervention program were to reduce significantly the rates of preterm deliveries and that of low birthweight neonates to at least the national rates. Pregnant women who received treatment at family health centers were interviewed and classified according to a preterm birth-risk screening scale. The scale was constructed for this project to measure the degree of risk according to medical, nursing and socioeconomic criteria. Women identified as at-risk were invited for more intensive medical, nursing and social follow-up, according to their individual needs. The intervention of a social worker was a special part of the project. The findings, after 4 years of project intervention, showed a significant decrease in the rate of preterm births: 8.6% in the control group before the program was implemented as compared to 5.4% in the case group (p less than 0.01). There was a decrease in the percentage of low birthweight neonates to 7.9% near the average rate for the Jewish population in Israel.(ABSTRACT TRUNCATED AT 250 WORDS)
全球已制定预防早产的项目,以降低围产期死亡率、儿童发病率和残疾率。贝特谢梅什干预项目除关注医疗护理方面外,还着重于找出并改善社会经济状况。选择贝特谢梅什(位于距耶路撒冷最近的医院西南30公里处;人口14000;每年有350 - 400例分娩)是因为其早产(36周及以下)率和低体重新生儿率高于全国水平,且社会经济地位较低,同时其当地卫生服务基础设施完善且易于利用。干预项目的主要目标是大幅降低早产率和低体重新生儿率,使其至少达到全国水平。在家庭健康中心接受治疗的孕妇接受了访谈,并根据早产风险筛查量表进行分类。该量表是为该项目构建的,用于根据医疗、护理和社会经济标准衡量风险程度。被确定为有风险的女性根据其个人需求被邀请接受更密集的医疗、护理和社会随访。社会工作者的干预是该项目的一个特殊部分。经过4年的项目干预,结果显示早产率显著下降:项目实施前对照组为8.6%,而干预组为5.4%(p小于0.01)。低体重新生儿的百分比降至7.9%,接近以色列犹太人口的平均水平。(摘要截短至250字)