South Australia

In South Australia, the preterm birth rate is 8.9%. Over the time of the Every Week Counts Preterm Birth Prevention Collaborative (2022-2024), this remained the same, however we did observe reductions in the rates of preterm birth in almost all the Local Hospital Networks’s who participated in the collaborative.

Additionally, significant reductions were observed in the early term birth rate across South Australia over the period of the collaborative, from 33.5% to 28.8%.

• Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. N-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD003402.
• Makrides M, Best K, Yelland L et al 2019 N-3 Supplementation in Pregnancy and the Incidence of Preterm Birth (New England Journal of Medicine, in press)

• Dr Amanda Poprzeczny, SA Medical Lead, Australian Preterm and Early Term Birth Prevention Program. Maternal Fetal Medicine specialist and Clinical Academic, the Women’s and Children’s Hospital and the University of Adelaide
• Belinda Nitschke, Project Manager and Jurisdictional Lead, SA Health Preterm and Early Term Birth Prevention Project
• Rebecca Smith, Principal Project Manager, Maternal, Neonatal and Gynaecology Strategic Executive Leadership Committee

We have observed a rise in early term birth rates since completion of the first part of the Collaborative project, suggesting a need to reinforce and consolidate the gains made previously.

We have regular and frequent trainee medical officer turnover at the three large hospital sites in South Australia such that education regarding timing and indication for birth needs to be frequent and regular. Additionally, we have a strong GP shared care program and fewer women accessing tertiary care early in pregnancy than previously.

Ensuring collaboration and support for GP’s is vital in preterm birth prevention, particularly in considering early identification of women at increased risk of spontaneous preterm birth or preterm preeclampsia.

Our goals in the next round of the Collaborative are to maintain gains made, particularly with regards reductions in early term birth, and embed changes and systems into standard practice.

We will be continuing to focus on reducing non-medically indicated early term birth, with a particular focus on ensuring all elective caesarean sections occur after 39 weeks. Additionally, we will be focusing on early identification of women at risk of preterm birth (spontaneous or medically indicated), and accessing appropriate prevention be it through cervical length surveillance or increased use of aspirin for prevention of preeclampsia.

An important aspect of this will be integrating risk identification into our electronic medical records and early pregnancy triage visits to ensure women at risk are identified and managed appropriately.