Racial disparity in the frequency of recurrence of preterm birth

Kistka, Zachary; Palomar, Lisanne; Lee, Kirstin A.; Boslaugh, Sarah; Wangler, Michael F.; Cole, F. Sessions; DeBaun, Michael R.; Muglia, Louis J.

doi:10.1016/j.ajog.2006.06.093

Cited by 191 publications

(143 citation statements)

References 21 publications

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“…In addition, black mothers have been shown to be at increased risk of recurrent preterm delivery and to receive different prenatal care. 13,14 These differences include decreased use of tocolysis, as compared to white mothers, consistent with the observed decrease in tocolysis in the present cohort from the second epoch. 15 In addition, the perinatal mortality rate in black infants is dramatically higher than in white infants even when controlling for early access to prenatal care, demographic characteristics, and pregnancy complications.…”

Section: Discussionsupporting

confidence: 67%

Maternal and neonatal characteristics of extremely low birth weight infants who die in the first day of life

Pont

Carter

2008

J Perinatol

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Objective: To determine changes over time in the characteristics of early extremely low birth weight non-survivors (E-ELBW-NS), maternal characteristics and perinatal management, and the documentation of perinatal consultations.Study Design: We conducted a chart review of infants <750 g who died within 24 h divided into two epochs: 1 January 1995 to 31 December 1999 and 1 January 2000 to 31 December 2005. Maternal and neonatal characteristics, delivery room resuscitation, post-resuscitation care, and documentation of resuscitation and perinatal counseling were examined.Result: A total of 138 infants met inclusion criteria. During Epoch 2, there was an increase in black, small for gestational age infants and prior maternal preterm delivery, and decreased incidences of tocolysis and chorioamnionitis. Also, a trend toward more hemolysis elevated liver enzymes and low platelet syndrome and decreased prenatal care existed. Perinatal consultations increased in both number and quality with time.Conclusion: There has been a shift in racial distribution toward more black infants in the second epoch perhaps reflecting disparities in care. Otherwise, demographics and management of E-ELBW-NS have changed minimally. There has been a significant improvement in the documentation of perinatal consultations.

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Section: Discussionsupporting

confidence: 67%

Maternal and neonatal characteristics of extremely low birth weight infants who die in the first day of life

Pont

Carter

2008

J Perinatol

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“…[46][47][48][49][50][51] The risk of recurrent preterm birth increases as the gestational age of the previous preterm birth declines and as the number of previous preterm births increases, and thus is highest in women with more than 1 early preterm birth. 52 Women with more than 1 preterm birth are also more likely to have prior early (<32 weeks) preterm birth, to demonstrate clinical and ultrasound evidence of short cervix (sonographic length <25 mm, and Bishop score >3), and to have a positive fibronectin at 22-24 weeks.…”

Section: Recurrent Vs Nonrecurrent Preterm Birthmentioning

confidence: 99%

Care for Women with Prior Preterm Birth

Iams

2010

Preterm Birth

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Women who have delivered an infant between 16 and 36 weeks' gestation have an increased risk of preterm birth in subsequent pregnancies. The risk increases with more than 1 preterm birth and is inversely proportional to the gestational age of the previous preterm birth. African American women have rates of recurrent preterm birth that are nearly twice that of women of other backgrounds. An approximate risk of recurrent preterm birth can be estimated by a comprehensive reproductive history, with emphasis on maternal race, the number and gestational age of prior births, and the sequence of events preceding the index preterm birth. Interventions including smoking cessation, eradication of asymptomatic bacteriuria, progestational agents, and cervical cerclage can reduce the risk of recurrent preterm birth when employed appropriately. Keywordscerclage; prevention; progesterone; recurrent; preterm birth; risk estimation Efforts to reduce the incidence of preterm birth cannot yet be called successful but have produced sufficient information to justify management suggestions for clinicians, not only for strategies that do not work but also for those that do. The quality and number of clinical trials of interventions intended to reduce the incidence and/or morbidity of preterm birth has risen substantially in recent years, yielding data that can improve care for women at risk.An important advance has been the revision of the traditional model of preterm birth in which painful contractions or preterm membrane rupture were understood as the most common initial steps preceding cervical change. This concept has been challenged by observations from several clinical studies:• Drugs that arrest or inhibit uterine contractions can delay delivery but do not reliably reduce or prevent preterm birth. [1][2][3][4][5] • Assessment of contraction frequency is not a useful test to predict preterm birth, 6 and its use to detect and arrest initial or recurrent episodes of preterm labor does not affect the rate of preterm birth. [7][8][9] • Antibiotics that eradicate microorganisms associated with preterm birth also do not reliably reduce, and may sometimes increase, the incidence of preterm birth, especially in women with intact membranes. [10][11][12][13][14][15][16][17] • Progestational agents such as 17α-hydroxy-progesterone caproate reduce recurrent preterm birth in some women with a prior preterm birth, 18,19 especially those with early preterm birth 20 and short cervix, 21 but have no effect on preterm birth in multiple gestations. 22,23 NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2013 May 09. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript• Cervical cerclage can reduce recurrent preterm birth in women with a prior preterm birth and short cervix 24,25 but increases the risk of preterm birth in women with multiple gestation who also have a short cervix. 24 These findings suggest the following 4 substantive changes in the "contractions change the cervi...

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“…Rates of preterm birth in specific ethnic groups, with genetic variation arising from geographic history, also indicate a role for genetics in preterm birth. For example, a higher incidence of preterm birth has been demonstrated when either the mother (Adams et al, 2000;Kistka et al, 2007) or father is African American. Several studies indicate that environmental risk factors are not sufficient to explain racial differences in preterm birth (e.g.…”

Section: Risk Factors For Preterm Birthmentioning

confidence: 99%

Preventing preterm birth: the past limitations and new potential of animal models

Ratajczak

Fay²,

Muglia

2010

Disease Models &Amp; Mechanisms

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The high rate of preterm birth in the USA and many other countries is a potential target for improving children's immediate health and reducing the medical problems they face as adults. The acute complications for infants born prematurely often require intensive care management and are followed by long-lasting cognitive, sensory, motor, and cardiovascular deficits that substantially limit adult capabilities and survival. The inability to effectively reduce preterm birth stems from the failure to understand normal mechanisms of parturition in humans. Although studies from several model organisms help define the physiology of maintenance and termination of pregnancy, there are fundamental differences between species. For example, species regulate their production of progesterone, the crucial hormone in sustaining pregnancy, differently. This limits the extent to which models can provide meaningful information about the physiological mechanisms of human gestation. The growing wealth of sequenced mammalian genomes, computational comparative genomic tools and systems biology approaches provides new potential to utilize the divergence of DNA sequences and physiology between species to understand the genetic underpinnings of preterm birth. Plunkett and Muglia, 2008). The association of these polymorphisms with disease is small and variable, but one emerging finding links racial differences in preterm birth frequency with a functional polymorphism in the promoter of a chaperone that is essential for collagen synthesis, SERPINH1. The mutation associated with preterm birth reduces the activity of the SERPINH1 promoter (Wang et al., 2006). This variant is increased in populations of African descent, and is associated with a 3.22-fold increase (95% confidence interval: 1.50-7.22) in the incidence of preterm birth associated with premature rupture of the fetal membranes. Disease Models & Mechanisms DMMSpontaneous idiopathic preterm birth may reflect acceleration of the normal gestational clock. Microarray data from uterine tissue reveals similar gene regulation patterns among women who labor prematurely and those who do not labor until their infants are full term (Bethin et al., 2003). The lack of distinguishing pathways between preterm and full-term gestation suggests that normal pathways may be accelerated in preterm birth. Thus, factors involved in normal pathway timing may be targets for predicting or preventing preterm birth.Infection deregulates the normal timing of parturition mechanisms. Mothers who deliver preterm infants, particularly at very early gestational ages, display an increased frequency of colonization with possibly pathologic microorganisms, even when they do not demonstrate overt evidence of infection (Watts et al., 1992;Onderdonk et al., 2008). Several animal models have been utilized to explore the normal timing mechanisms of parturition and the consequences of infection to elucidate pathways for preterm birth. Although they do not recapitulate the human disease in full, they do offer valuable insight...

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Racial disparity in the frequency of recurrence of preterm birth

Cited by 191 publications

References 21 publications

Maternal and neonatal characteristics of extremely low birth weight infants who die in the first day of life

Maternal and neonatal characteristics of extremely low birth weight infants who die in the first day of life

Care for Women with Prior Preterm Birth

Preventing preterm birth: the past limitations and new potential of animal models

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