Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis

Abstract

ObjectiveTo determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies.DesignSystematic review and meta-analysis using random effects models.Data sourcesAn electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017) and ClinicalTrials.gov (completed studies effective 2017), supplemented by hand-searching bibliographies of included studies, to find all studies with original data concerning recurrent sPTB.Study eligibility criteriaStudies had to include women with at least one spontaneous preterm singleton live birth (<37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. The Newcastle-Ottawa Scale was used to assess study quality.ResultsOverall, 32 articles involving 55 197 women, met all inclusion criteria. Generally studies were well conducted and had a low risk of bias. The absolute risk of recurrent sPTB at <37 weeks’ gestation was 30% (95% CI 27% to 34%). The risk of recurrence due to preterm premature rupture of membranes (PPROM) at <37 weeks gestation was 7% (95% CI 6% to 9%), while the risk of recurrence due to preterm labour (PTL) at <37 weeks gestation was 23% (95% CI 13% to 33%).ConclusionsThe risk of recurrent sPTB is high and is influenced by the underlying clinical pathway leading to the birth. This information is important for clinicians when discussing the recurrence risk of sPTB with their patients.

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

“…PROM was significantly associated with PTB. This is similar with systematic review and meta-analysis study [18].…”

“…Many studies in different settings of the world revealed the contributing factors of PTB as physical activity [8], maternal cardiovascular disease [9], delivering by previous cesarean section [10], had history of miscarriage [11], and history of PTB [11][12][13]. The contributing factors for PTB also include pregnancy interval [14], body mass Indexes(BMII) [11], antenatal care(ANC) [12,15,16], multiple pregnancy [17], antepartum hemorrhage(APH) [15],urinary tract infections(UTI) [11], premature rupture of membrane(PROM) [15,18], and pregnancy induced hypertension(PIH) [17,19]. Moreover, marital status [12], polyhydramnios or oligohydramnios and genitourinary infections [20], periodontal disease [11], ascending infection (bacteriuria) [21] and exposure to intimate partner violence (IPV) [15,22] are included in contributing factors of PTB.…”

Quality of life among parents of preterm infants: a scoping review

“…At the same time, results coherently showed that parental QoL benefits from the fact that parents did not perceive a preterm delivery as a disruptive event for the family. In a context where a preterm delivery constitutes a risk factor for recurrence in subsequent pregnancies [42], parents tended to change their plans for reproductive trajectories when their first pregnancy ended with a preterm delivery [43], which may have a negative impact on family QoL. These findings call for the need to explore in depth the role of several coping strategies to handle adversity and to deal with a preterm delivery [44,45] as a factor influencing positively parental and family QoL.…”

Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis

“…15–27 A recent meta-analysis reported that the overall risk of recurrent spontaneous preterm birth <37 weeks of gestation was 30%. 28 A short cervix, conventionally defined as a transvaginal sonographic cervical length ≤25mm in the midtrimester of pregnancy, is also an important risk factor for spontaneous preterm delivery and has emerged as one of the strongest and most consistent predictors of preterm birth in asymptomatic women with a singleton or twin gestation. 29–67 …”