Specialised antenatal clinics for women with a pregnancy at high risk of preterm birth (excluding multiple pregnancy) to improve outcomes for women and babies

Women who have had a previous preterm birth are at increased risk of having another premature birth. Babies who are born before the 37th week of pregnancy, and particularly those born before the 34th week, are at greater risk of suffering problems at birth and of disability in childhood. 'Specialised' antenatal clinics have been suggested for women at high risk of a preterm birth as a way of improving health outcomes for the women and their infants. This review of three randomised controlled trials involving 3400 women in the USA found that there was no reduction in the number of preterm births in women attending specialised antenatal clinics. The results were difficult to interpret, as the trials were conducted in slightly different ways and offered slightly different care. The trials were all conducted in the 1980s, before the introduction of many of the screening tests currently offered in specialised antenatal clinics such as ultrasound assessment of cervical length. There was no information available on the effect of specialised antenatal care on maternal wellbeing or long-term outcome.