Dataset Information

Risk factors associated with preterm birth after a prior term delivery.

ABSTRACT:

Objective

The objective of this study was to assess the presence of newly acquired preterm birth (PTB) risk factors among primiparous women with no prior history of PTB.

Design

Case-control study.

Setting

Deliveries occurring within a large healthcare system from 2002 to 2012.

Population

Women with their first two consecutive pregnancies carried to ?20(0/7) weeks' gestation.

Methods

Those delivering the first pregnancy at term and the second preterm ?20(0/7) and <37(0/7) weeks (term-preterm cases) were compared with women with a term birth in their first two pregnancies (term-term controls). Social factors with the potential to change between the first and second pregnancies and intrapartum labour characteristics in the first pregnancy were compared between cases and controls.

Main outcome measures

Risk factors for term-preterm sequence.

Results

About 38 215 women met inclusion criteria; 1353 (3.8%) were term-preterm cases. Cases and controls were similar with regard to race/ethnicity and maternal age at the time of the first and second deliveries. Cases delivered their second pregnancy approximately 3 weeks earlier (35.7 versus 39.1, P < 0.001). In multivariable models accounting for known PTB risk factors, women with a caesarean delivery in the first pregnancy [adjusted odds ratio (aOR) = 2.20; 95% confidence interval (CI) 1.57-3.08], new tobacco use (aOR = 2.33; 95% CI 1.61-3.38), and an interpregnancy interval <18 months (aOR = 1.37; 95% CI 1.21-1.55) were at increased risk of term-preterm sequence.

Conclusion

Caesarean delivery in the first pregnancy, new tobacco use, and short interpregnancy interval <18 months are significant risk factors for term-preterm sequence. Women should receive postpartum counselling regarding appropriate interpregnancy interval and cessation of tobacco use.

Tweetable abstract

Caesarean delivery in the 1st pregnancy is a significant risk factor for preterm birth following a term delivery.

SUBMITTER: Wong LF

PROVIDER: S-EPMC4809794 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Risk factors associated with preterm birth after a prior term delivery.

Wong L F LF Wilkes J J Korgenski K K Varner M W MW Manuck T A TA

BJOG : an international journal of obstetrics and gynaecology 20150928 11

<h4>Objective</h4>The objective of this study was to assess the presence of newly acquired preterm birth (PTB) risk factors among primiparous women with no prior history of PTB.<h4>Design</h4>Case-control study.<h4>Setting</h4>Deliveries occurring within a large healthcare system from 2002 to 2012.<h4>Population</h4>Women with their first two consecutive pregnancies carried to ≥20(0/7) weeks' gestation.<h4>Methods</h4>Those delivering the first pregnancy at term and the second preterm ≥20(0/7) ...[more]

PMID: 26412012

Similar Datasets

Project description:OBJECTIVE:To explore conditions and outcomes of a first delivery at term that might predict later preterm birth. DESIGN:Population based, prospective register based study. SETTING:Medical Birth Registry of Norway, 1999-2015. PARTICIPANTS:302?192 women giving birth (live or stillbirth) to a second singleton child between 1999 and 2015. MAIN OUTCOME MEASURES:Main outcome was the relative risk of preterm delivery (<37 gestational weeks) in the birth after a term first birth with pregnancy complications: pre-eclampsia, placental abruption, stillbirth, neonatal death, and small for gestational age. RESULTS:Women with any of the five complications at term showed a substantially increased risk of preterm delivery in the next pregnancy. The absolute risks for preterm delivery in a second pregnancy were 3.1% with none of the five term complications (8202/265?043), 6.1% after term pre-eclampsia (688/11?225), 7.3% after term placental abruption (41/562), 13.1% after term stillbirth (72/551), 10.0% after term neonatal death (22/219), and 6.7% after term small for gestational age (463/6939). The unadjusted relative risk for preterm birth after term pre-eclampsia was 2.0 (95% confidence interval 1.8 to 2.1), after term placental abruption was 2.3 (1.7 to 3.1), after term stillbirth was 4.2 (3.4 to 5.2), after term neonatal death was 3.2 (2.2 to 4.8), and after term small for gestational age was 2.2 (2.0 to 2.4). On average, the risk of preterm birth was increased 2.0-fold (1.9-fold to 2.1-fold) with one term complication in the first pregnancy, and 3.5-fold (2.9-fold to 4.2-fold) with two or more complications. The associations persisted after excluding recurrence of the specific complication in the second pregnancy. These links between term complications and preterm delivery were also seen in the reverse direction: preterm birth in the first pregnancy predicted complications in second pregnancies delivered at term. CONCLUSIONS:Pre-eclampsia, placental abruption, stillbirth, neonatal death, or small for gestational age experienced in a first term pregnancy are associated with a substantially increased risk of subsequent preterm delivery. Term complications seem to share important underlying causes with preterm delivery that persist from pregnancy to pregnancy, perhaps related to a mother's predisposition to disorders of placental function.

Dataset Information

Risk factors associated with preterm birth after a prior term delivery.

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusion

Tweetable abstract

Publications

Risk factors associated with preterm birth after a prior term delivery.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets