Impact of additional risk factors on the incidence of preterm delivery among pregnant women diagnosed with short cervix

Samejima, Taiki; Nagamatsu, Takeshi; Iriyama, Takayuki; Nakayama, Tsuneyoshi; Seyama, Takahiro; Sayama, Seisuke; Kumasawa, Keiichi; Komatsu, Akira; Kawana, Kei; Osuga, Yutaka; Fujii, Tomoyuki

doi:10.1016/j.tjog.2020.01.005

Cited by 15 publications

(13 citation statements)

References 19 publications

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“…Whether the presence/absence of uterine contractions at admission in women with cervical shortening could affect short‐term prognoses, such as delivery within 48 h, 7 days, or 14 days of presentation, or long‐term prognoses, such as SPTB before 34, 35, or 37 weeks, has not been extensively evaluated. We searched PubMed using the key words of (“Uterine cervical incompetence” [MH] OR “cervical length” OR “cervical shortening”) AND pregnancy AND ultrasonography, and found 1731 articles (searched on April 26, 2022); however, to the best of our knowledge, only two studies evaluated the effect of the presence/absence of uterine contractions on the occurrence of short‐term and/or long‐term prognoses in women with cervical shortening 13,14 . Mirza et al 13 examined a cohort of women with a CL less than 1.5 cm at 23–28 weeks of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Although the sample size was relatively small, the authors concluded that women with cervical shortening and uterine contractions showed an almost 16‐fold higher risk of delivery within 14 days compared with those with no uterine contractions 13 . Samejima et al 14 examined a cohort of women with cervical shortening (≤25 mm) during routine universal screening at 22–33 weeks of pregnancy. In 134 women with cervical shortening with a singleton pregnancy, PTB before 37 weeks occurred in 27.6%; 57% had uterine contraction at diagnosis; presence of uterine contraction was a risk factor for the occurrence of PTB before 37 weeks with a cOR of 4.56 (95% CI 1.83–11.4); the presence of uterine contraction at diagnosis was also an independent risk factor after adjusting for the effects of C‐reactive protein and white blood cell count on the day of diagnosis 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Samejima et al 14 examined a cohort of women with cervical shortening (≤25 mm) during routine universal screening at 22–33 weeks of pregnancy. In 134 women with cervical shortening with a singleton pregnancy, PTB before 37 weeks occurred in 27.6%; 57% had uterine contraction at diagnosis; presence of uterine contraction was a risk factor for the occurrence of PTB before 37 weeks with a cOR of 4.56 (95% CI 1.83–11.4); the presence of uterine contraction at diagnosis was also an independent risk factor after adjusting for the effects of C‐reactive protein and white blood cell count on the day of diagnosis 14 . Although CL at diagnosis was a risk factor for PTB, the effect of shorter CL at diagnosis was not adjusted in the multivariate analysis, probably because of a small sample size 14 .…”

Section: Discussionmentioning

confidence: 99%

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Uterine contraction may not be an independent risk factor for spontaneous preterm birth before 35 weeks in women with cervical shortening

Horie

Takahashi

Mieno

et al. 2022

Intl J Gynecology & Obste

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Objective To compare the risk of spontaneous preterm birth (SPTB) before 35 weeks in symptomatic and asymptomatic women with cervical shortening at 16–34 weeks under mid‐trimester universal screening of cervical length (CL). Method Multicenter retrospective cohort study involving six secondary/tertiary perinatal centers was planned in 2016. Primary outcomes were SPTB before 35 weeks. In all, 407 women were analyzed using multivariable logistic regression analysis for predicting SPTB before 35 weeks while adjusting for presence/absence of uterine contraction, gestational weeks, vaginal bleeding, and CL classification (1–9, 10–14, 15–19, and 20–24 mm) at admission, the execution of cervical cerclage, and the presence/absence of past history of preterm delivery. Results SPTB before 35 weeks of pregnancy occurred in 14.5%. Presence of uterine contraction was not an independent risk factor for SPTB before 35 weeks (adjusted odds ratio [aOR] 1.22, 95% confidence interval [CI] 0.67–2.20). CL of 1–9 mm, CL of 10–14 mm, and vaginal bleeding at admission were independent risk factors for SPTB before 35 weeks (aOR 5.35, 95% CI 2.11–13.6; aOR 2.79, 95% CI 1.12–6.98; and aOR 2.37, 95% CI 1.12–5.10, respectively). Conclusion In women with a cervical shortening at 16–34 weeks, presence of uterine contractions at admission may not be an independent risk factor for the occurrence of SPTB before 35 weeks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Uterine contraction may not be an independent risk factor for spontaneous preterm birth before 35 weeks in women with cervical shortening

Horie

Takahashi

Mieno

et al. 2022

Intl J Gynecology & Obste

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View full text Add to dashboard Cite

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“…In Thailand, the case of premature birth and congenital defects were the most prevalent. Maternal age, pre-pregnancy body mass index (BMI), prior history of preterm delivery, and no prenatal care were the major causes of preterm birth and congenital defects (27). According to WHO Southeast Asia Regional Office (SEARO) in 2013, congenital malformations in Thailand were dominated by heart defect, hemoglobin anomaly, nervous system defects, and genetic defect syndrome (28).…”

Section: Discussionmentioning

confidence: 99%

The Trends of Neonatal Mortality Rate Among South East Asia Countries from 2000-2017

Soleman

2020

Dis. Prevention and Public Health J.

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Background: Neonatal MortalityRate (NMR) reflects the quality of health services provided by the government. It is very important to disclose the health system capability of each country in managing mother and child health programs because it is an essential health policy that should be prioritized. The health system capability of a country will determine the welfare and social guarantee because most of NMR causes are preventable. Several components such as maternal factors, neonatal and health services were determined as predictors of NMR. The objective of this study is to compare neonatal mortality trends among eight South East Asia Countries (SEAC) from 2000 to 2017. Method: A cross-sectional design was used to analyze the data regarding the causes of neonatal death between 2000 and 2017. Data were taken from World Health Organization Maternal Child Epidemiology Estimation (WHO MCEE) database.The collected data were live birth; neonatal mortality rate; and the big five of neonatal mortality etiologies in the eight SEAC. Data were then analyzed descriptively with line chart to describe the trend of NMR. Result: This study found that Indonesia had the highest neonatal mortality rate, yet the trend decreased gradually from 102.700 in 2000 to 60.986 in 2017, followed by Philippines, Vietnam, Myanmar, Cambodia, Thailand, Laos, and Malaysia respectively. On the other hand, the trend of live birth was the lowest in Indonesia and the highest in Philippines . According to the data regarding the leading cause of NMR, preterm birth was the major cause of neonatal mortality followed by birth asphyxia and congenital defects. Conclusion: Indonesia has the highest mortality rate, yet the etiology such as as premature birth, asphyxia, and congenital disorder is similar to the other eight countries.

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“…Spontaneous preterm birth occurs due to spontaneous preterm labour or preterm rupture of fetal membranes before the onset of labour and accounts for two-thirds of preterm birth. 1,2 About 15 million pregnancies end up with preterm delivery worldwide. 3 Prematurity is the leading cause of neonatal mortality and morbidity, and affects mostly the neonates borne before 34 weeks of gestation, accounting for 70-80% of perinatal details.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of 17-Alpha-Hydroxyprogesterone in the Prevention of Preterm Labour

Urooj

Khan²,

Parveen³

et al. 2023

PAFMJ

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Objective: To compare the effectiveness of 17-Alpha- Hydroxyprogesterone in preventing preterm labour. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital, Sakardu Pakistan, from Jun to Dec 2019. Methodology: A total of 208 patients (104 in each group) were recruited in this study. Group-A 17-alpha-hydroxyprogesterone (250mg) intramuscular injection was given weekly from 20-36 weeks of gestation or delivery, whichever occurred first. GroupB (Control Group) received no treatment except routine antenatal care but was treated actively with tocolytic drugs and corticosteroids if they presented with preterm labour. Results: Mean age of the patients was 26.1±4.9 and 25.7±4.5 in Group-A and B, respectively. In Group-A (17-alphahydroxyprogesterone), the mean gestational age at delivery was 36.8±3.8; in Group-B (control), the mean gestational age was 35.7±1.3. Treatment was efficacious in 82 patients (78.8%) in Group-A and 65(62.5%) in Group-B. The difference was statistically significant between the two groups (p=0.009). Conclusion: 17 Alpha-Hydroxyprogesterone caproate preventive therapy likely plays an important role in reducing the risk of recurrent preterm birth.

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Impact of additional risk factors on the incidence of preterm delivery among pregnant women diagnosed with short cervix

Cited by 15 publications

References 19 publications

Uterine contraction may not be an independent risk factor for spontaneous preterm birth before 35 weeks in women with cervical shortening

Uterine contraction may not be an independent risk factor for spontaneous preterm birth before 35 weeks in women with cervical shortening

The Trends of Neonatal Mortality Rate Among South East Asia Countries from 2000-2017

Effectiveness of 17-Alpha-Hydroxyprogesterone in the Prevention of Preterm Labour

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