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\begin{document}

\title{Impact of antenatal lifestyle education on reducing preterm birth: A
retrospective cohort study}



\author[1]{Na Wang}%
\author[1]{Jie Lu}%
\author[1]{Yan ZHAO}%
\author[1]{Yuan Wei}%
\author[2]{Jennifer Gamble}%
\author[2]{Debra Creedy}%
\affil[1]{Peking University Third Hospital}%
\affil[2]{Griffith University}%


\vspace{-1em}



  
  \date{June 18, 2024}


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\selectlanguage{english}
\begin{abstract}
Objective Investigate the effect of an antenatal lifestyle education
seminar on reducing preterm birth, and whether education timing modifies
outcomes among women with different characteristics. Design
Retrospective cohort study Setting A metropolitan hospital in Beijing,
China Population A total of 3008 singleton livebirths Methods Extracted
data from deidentified electronic medical records were analyzed. Odds
ratios (ORs) for preterm birth according to antenatal education
attendance using stepwise binary logistic regression stratified by
different maternal characteristics was conducted. Outcome measure
Preterm birth (gestational age \textless{}37+0 weeks) Results Overall
prevalence of preterm birth was 8.7\%, but higher for women who did not
attend the antenatal seminar (11.5\%). Risk of preterm birth for first
trimester attendees decreased by 53\% ({[}OR{]} 0.47, 95\% CI
0.35-0.64), and 41\% for later attendees ({[}OR{]} 0.59, 95\% CI
0.41-0.86). Estimates persisted after adjusting pre-existing and
gestational covariates. In subgroup analysis, young or nulliparous women
who attended later than first trimester were at decreased risk. For
women aged [?]35 years, multiparous, who had a previous caesarean
section/myomectomy, the risk of preterm birth was reduced among first
trimester attendees, but no longer significant after adjusting for
pre-existing and gestational covariates (p \textgreater{} 0.05). Timing
of the seminar was not significant for women received assisted
reproductive technologies. Conclusions Offering an antenatal lifestyle
education seminar was associated with lower preterm birth risk and was
modified by education timing and women's characteristics. Results can
inform the development of tailored preterm birth prevention strategies.
Keywords Antenatal education, lifestyle factors, preterm birth,
intervention timing, health promotion.%
\end{abstract}%



\sloppy


\textbf{Title} Impact of antenatal lifestyle education on reducing
preterm birth: A retrospective cohort study

\textbf{Author information}

\begin{enumerate}
\tightlist
\item
  Na WANG \textsuperscript{a,b}
\item
  Jie LU \textsuperscript{a}
\item
  Yan ZHAO \textsuperscript{a}
\item
  Yuan Wei \textsuperscript{a}
\item
  Debra K. CREEDY \textsuperscript{c}
\item
  Jenny GAMBLE\textsuperscript{c}
\end{enumerate}

\begin{enumerate}
\tightlist
\item
  Department of Gynaecology and Obstetrics, Peking University Third
  Hospital, 49 Huayuan Beilu Road, Haidian District, Beijing, 100191,
  China
\item
  School of Nursing, Capital Medical University, 10 Xitoutiao Road,
  Fengtai District, Beijing, 100069, China
\item
  School of Nursing and Midwifery, Griffith University Logan Campus,
  University Drive, Meadowbrook, Queensland, 4131, Australia.
\end{enumerate}

Corresponding author: Jie LU, Department of Gynaecology and Obstetrics,
Surgical inpatient building No.2, 49 Huayuan Beilu Road, Haidian
District, Beijing, 100191, China.Telephone: 86-10-82266699. Email:
littlerain5827@263.net

\textbf{The shortened running title:} Antenatal lifestyle education
timing and preterm birth

\subsection*{Abstract}

{\label{abstract}}

\textbf{Objective} Investigate the effect of an antenatal lifestyle
education seminar on reducing preterm birth, and whether education
timing modifies outcomes among women with different characteristics.

\textbf{Design} Retrospective cohort study

\textbf{Setting} A metropolitan hospital in Beijing, China

\textbf{Population} A total of 3008 singleton livebirths

\textbf{Methods} Extracted data from deidentified electronic medical
records were analyzed. Odds ratios (ORs) for preterm birth according to
antenatal education attendance using stepwise binary logistic regression
stratified by different maternal characteristics was conducted.

\textbf{Outcome measure} Preterm birth (gestational age
\textless{}37\textsuperscript{+0} weeks)

\textbf{Results} Overall prevalence of preterm birth was 8.7\%, but
higher for women who did not attend the antenatal seminar (11.5\%). Risk
of preterm birth for first trimester attendees decreased by 53\%
({[}OR{]} 0.47, 95\% CI 0.35-0.64), and 41\% for later attendees
({[}OR{]} 0.59, 95\% CI 0.41-0.86). Estimates persisted after adjusting
pre-existing and gestational covariates. In subgroup analysis, young or
nulliparous women who attended later than first trimester were at
decreased risk. For women aged [?]35 years, multiparous, who had a
previous caesarean section/myomectomy, the risk of preterm birth was
reduced among first trimester attendees, but no longer significant after
adjusting for pre-existing and gestational covariates (p \textgreater{}
0.05). Timing of the seminar was not significant for women received
assisted reproductive technologies.

\textbf{Conclusions} Offering an antenatal lifestyle education seminar
was associated with lower preterm birth risk and was modified by
education timing and women's characteristics. Results can inform the
development of tailored preterm birth prevention strategies.

\textbf{Keywords} Antenatal education, lifestyle factors, preterm birth,
intervention timing, health promotion.

\textbf{Tweetable abstract} A brief antenatal lifestyle education lowers
preterm birth risk but is modified by education timing.

\textbf{Hosted file}

\verb`3. Manuscript antenatal education & preterm birth_211031.docx`  available at \url{https://authorea.com/users/444092/articles/543903-impact-of-antenatal-lifestyle-education-on-reducing-preterm-birth-a-retrospective-cohort-study}

\textbf{Hosted file}

\verb`4. Figure_210906.dotx`  available at \url{https://authorea.com/users/444092/articles/543903-impact-of-antenatal-lifestyle-education-on-reducing-preterm-birth-a-retrospective-cohort-study}

\selectlanguage{english}
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\end{document}

