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)
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