Central Ohio's rate of premature births is among the highest in the state. Premature births are the leading cause of death for newborns in Franklin County, and like other metropolitan areas in the state, preterm birth rates have continued to increase since 1980.

Central Ohio's rate of premature births is among the highest in the state. Premature births are the leading cause of death for newborns in Franklin County, and like other metropolitan areas in the state, preterm birth rates have continued to increase since 1980.

The immediate and long-term consequences of preterm births include health and developmental issues, family stress and tremendous economic ramifications.

A new community prevention initiative -- Ohio Better Birth Outcomes (OBBO) -- focuses on reducing the frequency of preterm births and its consequences. Nationwide Children's Hospital has partnered with the three other health systems of the Central Ohio Hospital Council, the Columbus Public Health Department and local government and community organizations to develop strategies that will address this healthcare issue.

Specific actions are effective in reducing preterm birth, and the Nurse-Family Partnership (NFP) at the Center for Child and Family Advocacy (CCFA) at Nationwide Children's Hospital is among one of the four proven approaches that are being practiced to reduce the number of preterm births in central Ohio.

NFP is a national, evidence-based program that partners registered nurses with low-income, first-time mothers. These mothers are at higher risk for having preterm births due to various factors related to poverty and maternal age. Women in the program are partnered with a registered nurse before their 28th week of pregnancy. The nurse makes weekly home visits throughout the duration of a woman's pregnancy, up to her child's second birthday. Throughout the program, the nurse covers a wide variety of topics that are most relevant to the mother, addressing her needs and encouraging her to be self-sufficient.

Through the NFP program, the preterm birth rate in central Ohio has been reduced by roughly 40 percent compared to mothers who were not receiving this support. Neonatal intensive care unit (NICU) dollars per participant have been reduced by approximately half, and NICU days per NFP participant are down by one-third.

Along with NFP, the other three proven interventions that are important part of the OBBO initiative are the Progesterone Caproate Project (17P), Central Ohio Scheduled Births Initiative (COSBI) and Safe Spacing (see sidebar for additional information).

Although treatment and care for children who are born prematurely have taken huge strides, there is still great opportunity to work toward preventing preterm births and lowering the rates of prematurity in central Ohio.

This is what OBBO will strive to accomplish through these strategies to effectively address this healthcare issue.

Along with the Nurse Family Partnership, three other approaches are being undertaken to reduce preterm births in Franklin County.

1. Safe Spacing
Mothers of preterm infants have an 80 percent chance of another preterm birth if they conceive again within six months of delivery. This program works with mothers to provide education on important postpartum topics such as breastfeeding, adhering to safe-spacing plans to prevent a subsequent preterm birth, and receiving assistance to address psychosocial issues. An important part of the Safe Spacing program is providing case management so women receive ongoing resources, transportation and counseling.

2. 17-Progesterone (17-P)
A woman who has one spontaneous preterm birth is 20 to 50 percent more likely to have another one. Prenatal therapy with weekly injections of 17P, a form of progesterone (a normal pregnancy hormone), can reduce recurrent preterm births by 35 percent and improve newborn health. The therapy is safe for both mother and baby.

3. Central Ohio Scheduled Birth Initiative (COSBI)
This program is an intervention designed not for mothers, but for doctors and hospitals. Infants born even a few weeks too early are at higher risk for respiratory and other life-threatening problems at birth. COSBI teaches hospitals and doctors about the importance of the last few weeks of pregnancy. The significant health risks to infants make it important to address unnecessary preterm deliveries. COSBI provides training and feedback to hospitals about their performance in this important area.

To hear more about these strategies and the overall OBBO initiative, visit www.ChildrensonQuallity.com.