The association between parity and spontaneous preterm birth: a population based study

Koullali, Bouchra; Zijl, Maud D. van; Kazemier, Brenda M.; Oudijk, Martijn A.; Mol, Ben W.; Pajkrt, Eva; Ravelli, Anita C.J.

doi:10.1186/s12884-020-02940-w

Cited by 93 publications

(87 citation statements)

References 28 publications

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“…Our results were consistent with several previous researches [ 15 , 17 , 18 , 21 , 27 ]. For example, a retrospective cohort included 51,086 women from 2002 to 2010 found that the birthweight-for-gestational-age z-score of infants to multiparous mothers was significantly increased compared to nulliparous mothers [ 15 ].…”

Section: Discussionsupporting

confidence: 94%

“…the number of offspring a female has delivered) was also found associated with adverse birth outcomes [ 15 , 16 ]. For example, a recent study with 837,226 singleton births conducted in the Netherlands has found that the risks of PTB, very PTB and extreme PTB were significantly higher in nulliparous mothers than women who had given at least one birth before (RR: 1.95, 95%CI: 1.89–2.00 for PTB; RR: 2.15, 95%CI: 1.98–2.33 for very PTB; and RR: 2.02, 95%CI: 1.78–2.29 for extreme PTB) [ 17 ]. The increased risk of nulliparity on LBW and SGA were also demonstrated in several previous studies [ 15 , 16 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Parity and the risks of adverse birth outcomes: a retrospective study among Chinese

Lin

Chen

et al. 2021

BMC Pregnancy Childbirth

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Background Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed. Methods This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25–29 years, 30–34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes. Results Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89–0.93), LBW (aRR = 0.74, 95% CI: 0.72–0.77) and SGA (aRR = 0.67, 95% CI: 0.66–0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70–0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84–0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years. Conclusion Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Parity and the risks of adverse birth outcomes: a retrospective study among Chinese

Lin

Chen

et al. 2021

BMC Pregnancy Childbirth

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“…We case matched the preterm participants 1:2 with participants who delivered at term (>37 weeks) with a singleton pregnancy. The case matching was performed based on age, parity and gravida [24].…”

Section: Participant Recruitment Clinical History and Sample Collecmentioning

confidence: 99%

Vaginal microbiota and cytokine levels predict preterm delivery in Asian women

Kumar

Murugesan

Singh

et al. 2020

Preprint

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Background: Preterm birth (PTB) is the most common cause of neonatal morbidity and mortality worldwide. Approximately half of PTBs are linked with microbial etiologies, including pathologic changes to the vaginal microbiota, which vary according to ethnicity. Globally more than 50% of PTBs occur in Asia, but studies of the vaginal microbiome and its association with pregnancy outcomes in Asian women are lacking. This study aimed to characterize the vaginal microbiome and cytokine environment of 18 Karen and Burman pregnant women who delivered preterm and 36 matched controls delivering at full term. Results: Using 16S ribosomal RNA gene sequencing we identified a predictive vaginal microbiota signature for PTB that was detectable as early as the first trimester of pregnancy, characterized by higher levels of Prevotella buccalis , and lower levels of Lactobacillus crispatus and Finegoldia , accompanied by decreased levels of cytokines including IFNγ, IL-4 and TNFα. Conclusion: Our findings highlight new opportunities to predict PTB in Asian women in low-resource settings who are at highest risk of adverse outcomes from unexpected PTB, as well as in Burman/Karen ethnic minority groups in high-resource regions.

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“…Prior studies have shown that women with higher pre-pregnancy BMI were more likely to develop pre-eclampsia and diabetes during pregnancy, which greatly increased the risk of PTB 32 . Primiparity is also known to be a risk factor for PTB 33 . Therefore, a logical explanation might be that the existence of strong risk factors for PTB such as obesity might mask the effects of ApoB/ApoA-1 on the occurrence of PTB.…”

Section: Discussionmentioning

confidence: 99%

Associations between maternal mid-pregnancy apolipoprotein A-1, apolipoprotein B, apolipoprotein B/apolipoprotein A-1 ratio and preterm birth: An observational study

Liu

Wang

et al. 2021

Preprint

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Objective: To investigate the association between maternal apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), ApoB/ApoA-1ratio and preterm birth (PTB). Design: Observational survey. Setting: Guangdong Women and Children Hospital, China Samples: 5986 pregnant women. Method: Data were extracted from the information system of Guangdong Women and Children Hospital. Maternal serum ApoB, ApoA-1 and ApoB/ApoA-1 ratio were categorized into tertiles. Logistic regression models were performed to evaluate the odds ratios and 95% confidence intervals for PTB. Main outcome measures: PTB (gestational age < 37 weeks) Results: Of the study participants, the rate of preterm birth was 5.7% (n= 344). Compare with individuals in the lowest tertile, the adjusted ORs of PTB was 1.41 (95% CI: 1.07-1.87) for individuals in the highest tertile of ApoB and 1.35 (95% CI: 1.03-1.78) for those in the highest tertile of ApoB/ApoA-1. The association of ApoB/ApoA-1 and PTB was more relevant among women with pre-pregnancy BMI ≤ 24 kg/m2, age at delivery ≥ 35 years or those who were multiparous. Conclusions: Elevated maternal ApoB level and ApoB/ApoA-1 ratio during mid-pregnancy were related to increased risk of PTB. Monitoring serum apolipoprotein levels may help to prevent preterm birth. Funding: The study was funded by grants 2019FYH003 from Chinese Center for Disease Control and Prevention. Keywords: Apolipoprotein A-1, Apolipoprotein B, Apolipoprotein B/Apolipoprotein A-1, Preterm birth Tweetable abstract：Maternal mid-pregnancy ApoB level and ApoB/ApoA-1 ratio were associated with PTB.

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The association between parity and spontaneous preterm birth: a population based study

Cited by 93 publications

References 28 publications

Parity and the risks of adverse birth outcomes: a retrospective study among Chinese

Parity and the risks of adverse birth outcomes: a retrospective study among Chinese

Vaginal microbiota and cytokine levels predict preterm delivery in Asian women

Associations between maternal mid-pregnancy apolipoprotein A-1, apolipoprotein B, apolipoprotein B/apolipoprotein A-1 ratio and preterm birth: An observational study

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