Heterogeneity of Preterm Birth Subtypes in Relation to Neonatal Death

Chen, Aimin; Feresu, Shingairai A.; Barsoom, Michael

doi:10.1097/aog.0b013e3181b473fc

Cited by 45 publications

(37 citation statements)

References 24 publications

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“…This suggests a profile of mothers with low socioeconomic and educational status compared with PTB-PPROM and PTB-M. Similar socio-demographic characteristics for PTB-I have been reported by other authors[10,28–29]. When the data were adjusted for maternal age, the main outcomes did not change.…”

Section: Discussionsupporting

confidence: 85%

Maternal and neonatal epidemiological features in clinical subtypes of preterm birth

Giménez

Krupitzki

Momany

et al. 2015

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective This study was designed to characterize and compare the maternal and newborn epidemiological characteristics through analysis of environmental factors, socio-demographic characteristics, and clinical characteristics between the different clinical subtypes of preterm birth (PTB): Idiopathic (PTB-I), premature rupture of the membranes (PTB-PPROM) and medically indicated (PTB-M). The two subtypes PTB-I and PTB-PPROM grouped are called spontaneous preterm births (PTB-S). Methods A retrospective, observational study was conducted in 1.291 preterm non-malformed singleton live-born children to nulliparous and multiparous mother’s in Tucumán-Argentina between 2005 and 2010. Over 50 maternal variables and ten newborn variables were compared between the different clinical subtypes. The comparisons were done to identify heterogeneity between subtypes of preterm birth: (PTB-S) vs. (PTB-M), and within spontaneous subtype: (PTB-I) vs. (PTB-PPROM). In the same way, two conditional logistic multivariate regressions were used to compare the odds ratio (OR) between PTB-S and PTB-M, as well as PTB-I and PTB-PPROM. We matched for maternal age when comparing maternal variables and gestational age when comparing infant variables. Results The PTB-I subtype was characterized by younger mothers of lower socioeconomic status, PTB-PPROM was characterized by environmental factors resulting from inflammatory processes, and PTB-M was characterized by increased maternal or fetal risk pregnancies. Conclusions The main risk factor for PTB-I and PTB-M was having had a prior preterm delivery, however previous spontaneous abortion was not a risk factor, suggesting a reproductive selection mechanism.

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Section: Discussionsupporting

confidence: 85%

Maternal and neonatal epidemiological features in clinical subtypes of preterm birth

Giménez

Krupitzki

Momany

et al. 2015

The Journal of Maternal-Fetal & Neonatal Medicine

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“…2): 71.5% at 24 weeks of gestation, 39.0% at 25 weeks of gestation, 25.5% at 26 weeks of [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], for placental abruption day 5 (interquartile range 3-7), and for isolated fetal growth restriction day 9 (interquartile range 4-31). Cause of preterm birth was associated with inhospital mortality (P5.01) in the bivariate analysis.…”

Section: Resultsmentioning

confidence: 99%

“…[15][16][17][18] Reviewing the papers using these categories, however, shows clearly that these terms are neither well defined nor consistently used and that the studies mostly fail to take confounding factors into account completely or even at all. 17,19,20 However, the most important flaw is that this classification is not based on the diseases responsible for the preterm birth; depending on the clinical circumstances, the same cause is found in both groups. Thus, preterm PROM can cause preterm delivery either after spontaneous labor or after a cesarean delivery before labor for chorioamnionitis.…”

Section: Discussionmentioning

confidence: 96%

Cause of Preterm Birth as a Prognostic Factor for Mortality

Delorme

Goffinet

Ancel

et al. 2016

Obstetrics &Amp; Gynecology

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“…Preterm birth was defined as live birth before 37 completed weeks of gestation, and classified into 3 subtypes using a previously published algorithm [6,15]. Since the NCHS files do not contain direct information on preterm birth subtypes, this algorithm used information on premature rupture of membranes, labour induction, etc, to assign the preterm birth subtype in the following sequence [6,15]: 1) preterm birth following premature rupture of membranes for over 12 hours (PROM); 2) iatrogenic preterm birth (preterm birth following labour induction or caesarean delivery without PROM or conditions indicating prior onset of labour); 3) spontaneous preterm birth (all other births).…”

Section: Methodsmentioning

confidence: 99%

“…Infants born following medically indicated preterm birth are at a two-fold higher risk of neonatal mortality as compared with infants born following spontaneous preterm birth [13-15]. If the risks of adverse birth outcomes among the different preterm birth subtypes have remained unchanged, a temporal increase in preterm neonatal mortality could be expected given the recent increase in iatrogenic preterm births.…”

Section: Introductionmentioning

confidence: 99%

Temporal trends in neonatal outcomes following iatrogenic preterm delivery

Lisonkova

Hutcheon

Joseph

2011

BMC Pregnancy Childbirth

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BackgroundPreterm birth rates have increased substantially in the recent years mostly due to obstetric intervention. We studied the effects of increasing iatrogenic preterm birth on temporal trends in perinatal mortality and serious neonatal morbidity in the United States.MethodsWe used data on singleton and twin births in the United States, 1995-2005 (n = 36,399,333), to examine trends in stillbirths, neonatal deaths, and serious neonatal morbidity (5-minute Apgar ≤3, assisted ventilation ≥30 min and neonatal seizures). Preterm birth subtypes were identified using an algorithm that categorized live births <37 weeks into iatrogenic preterm births, births following premature rupture of membranes and spontaneous preterm births. Temporal changes were quantified using odds ratios (OR) and 95% confidence intervals (CI).ResultsAmong singletons, preterm birth increased from 7.3 to 8.8 per 100 live births from 1995 to 2005, while iatrogenic preterm birth increased from 2.2 to 3.7 per 100 live births. Stillbirth rates declined from 3.4 to 3.0 per 1,000 total births from 1995-96 to 2004-05, and neonatal mortality rates declined from 2.4 to 2.1 per 1,000 live births. Temporal declines in neonatal mortality/morbidity were most pronounced at 34-36 weeks gestation and larger among iatrogenic preterm births (OR = 0.75, CI 0.73-0.77) than among spontaneous preterm births (OR = 0.82, CI 0.80-0.84); P < 0.001. Similar patterns were observed among twins, with some notable differences.ConclusionIncreases in iatrogenic preterm birth have been accompanied by declines in perinatal mortality. The temporal decline in neonatal mortality/serious neonatal morbidity has been larger among iatrogenic preterm births as compared with spontaneous preterm births.

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Heterogeneity of Preterm Birth Subtypes in Relation to Neonatal Death

Abstract: II.

Cited by 45 publications

References 24 publications

Maternal and neonatal epidemiological features in clinical subtypes of preterm birth

Maternal and neonatal epidemiological features in clinical subtypes of preterm birth

Cause of Preterm Birth as a Prognostic Factor for Mortality

Temporal trends in neonatal outcomes following iatrogenic preterm delivery

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