Early term birth is associated with the risk of preterm and recurrent early term birth in women with 3 consecutive deliveries
Eran AshwalEmmanuel AttaliNir MelamedKarina Krajden HaratzAmir AviramEran HadarYariv YogevLiran Hiersch
0
Citation
42
Reference
10
Related Paper
Background
Despite extensive evaluation, our understanding of risk factors for premature delivery is incomplete.Objective
To examine whether a woman's health status and risk factors before pregnancy are associated with a woman's risk of preterm delivery, independent of risk factors that occur during pregnancy.Design, Setting, and Participants
Prospective cohort of pregnant women in the San Francisco Bay area who delivered a singleton infant (n = 1619).Main Outcome Measure
Preterm delivery (<37 weeks' gestational age).Results
Sociodemographic characteristics alone explained 13.0% of the risk of preterm delivery, whereas risk factors that occurred before pregnancy explained 39.8% and risk factors that occurred during pregnancy explained 47.1%. After we adjusted for sociodemographic characteristics, prepregnancy risk factors, and pregnancy risk factors, women who reported poor physical function during the month before conception were nearly twice as likely to experience a preterm delivery (odds ratio, 1.97; 95% confidence interval, 1.18-3.30) as women with better physical function.Conclusion
A broader focus on the health of women prior to pregnancy may improve rates of preterm delivery.Premature birth
Cite
Citations (125)
// Jun Wei 1 , Qi-Jun Wu 2 , Tie-Ning Zhang 3 , Zi-Qi Shen 1 , Hao Liu 1 , Dong-Ming Zheng 1 , Hong Cui 1 , Collaborative Group on Twin Birth and Fetal Abnormality in China, Cai-Xia Liu 1 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China 2 Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China 3 Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China Correspondence to: Cai-Xia Liu, e-mail: liucx1716@163.com Keywords: China, cross-sectional study, multiple births, pregnancy complications Received: January 10, 2016 Accepted: April 02, 2016 Published: April 26, 2016 ABSTRACT Complications in women with multiple gestation pregnancy have not been studied in China. We aimed to establish a database of women with multiple gestation pregnancy and investigate the complications related to multiple pregnancy. We conducted a cross-sectional study that included 3246 women with multiple gestation pregnancy and who had multiple live-birth deliveries; the women were registered at ten maternal-fetal medicine centers in China in 2013. All participants completed a detailed questionnaire that included basic demographic information, history of gestation and abnormal fetal development, risk factors during pregnancy, and pregnancy outcomes. Overall, 1553 (47.8%) women experienced pregnancy complications; these women were more likely to have lower height and less education than women who did not experience complications. However, women who experienced complications had a higher twin birth rate and were more likely to have received regular antenatal care and assisted reproductive technology than women without complications ( P < 0.05). Notably, preterm birth was a primary complication in multiple pregnancy ( n = 960). In conclusion, pregnancy complications, especially preterm birth, were relatively common in women with multiple gestation pregnancy. The findings from this cross-sectional study in China may be used as a foundation for investigating risk factors for complications in women with multiple gestation pregnancy in the future.
Cross-sectional study
Cite
Citations (33)
Objective is to evaluate the effectiveness of the developed method of preventing pregnancy complications with low placentation from early gestation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made at 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location who underwent prevention from pregnancy complications in early gestation by the complex of medicines developed by us and a control group -55 women with low placentation who had not undergone complications prophylaxis from early gestational periods. The prophylactic complex included Luteina, ginkgo biloba extract, folio and biolectra. To assess the effectiveness of the therapy in the study groups, we analyzed the course of pregnancy in early and late gestation, as well as complications of pregnancy and delivery.Results. The frequency of pregnancy pathologies in the main group, where the prevention of pregnancy complications from early gestation with low placentation, was significantly lower than in the control group. According to the study, the risk of abortion with bleeding and without bleeding in the first and second trimesters significantly decreased in the main group of pregnant women (p<0.05). In the third trimester of gestation in the group where the prevention of pregnancy complications was significantly reduced, the incidence of preterm birth, premature detachment of the low-lying placenta, fetoplacental dysfunction, fetal developmental delay syndrome and fetal distress during pregnancy (p<0.05). Also, in the main group there was a lower percentage of premature births and births that ended by cesarean section.Conclusions. 1. The place of attachment of the placenta in the uterine cavity is closely related to its function, the development of placental dysfunction, pregnancy and delivery. 2. Studies have shown the effectiveness of our proposed comprehensive drug prevention of complications of pregnancy with low placentation, which in turn has led to improved pregnancy and delivery and has become an effective means of preventing placental dysfunction.
Placentation
Cite
Citations (0)
We investigated whether nonsurgical termination of pregnancy after 14 weeks of gestation increases the risk of preterm delivery in a subsequent pregnancy. We conducted a two-centre retrospective case-control study. Patients who underwent non-surgical termination of pregnancy after 14 weeks of gestation between 2012 and 2015 and who gave birth after 14 weeks of gestation to a live-born singleton infant were included. Control patients were those who gave birth after 37 weeks of gestation (the same month as a case patient) and had a second delivery of a singleton foetus after 14 weeks of gestation. The primary outcome was preterm delivery during the second pregnancy period. We included 151 cases and 302 controls and observed 13 (8.6%) preterm births during the second pregnancy in the case group versus 8 (2.6%) (odds ratio: 3.62; 95% confidence interval: 1.40–8.65, p < .001) in the control group. This result remained significant after multivariate analysis. Impact statementWhat is already known about this topic? Many studies have evaluated the association between first-trimester surgical or non-surgical termination of pregnancy and the risk of preterm birth in the subsequent pregnancy. However, no study has evaluated the association between second- or third-trimester non-surgical termination of pregnancy due to foetal disease and the risk of preterm birth in the subsequent pregnancy. A small number of studies have included a small proportion of patients who previously underwent non-surgical termination of pregnancy after 14 weeks of gestation and later experienced first-trimester termination during their second pregnancy. These studies focussed on the impact of the interpregnancy interval or pharmacological induction of labour on the risk of preterm delivery in the subsequent pregnancy.What did the results of this study add? This is the first study to specifically evaluate the association between second- and third-trimester non-surgical terminations of pregnancy and the risk of preterm birth in the subsequent pregnancy. When compared with term birth, nonsurgical termination of pregnancy was associated with the risk of spontaneous preterm birth and hospitalisation in the neonatal intensive care unit in the subsequent pregnancy.What are the implications of these findings for clinical practice and further research? Further studies are required to confirm our results, but information delivered to patients with a late termination of pregnancy and during their pregnancy follow-up for the subsequent pregnancy could be modified to provide this information.
Cite
Citations (1)
Objective To investigate the importance of enhancing the monitoring and management of pregnancy and delivery in elderly pregnant women,and to reduce the harmful influence to mothers and infants due to the unsuitable treatments. Methods The pregnant women who had singleton pregnancy were divided into elderly group and non-elderly group.We observed the complications of gestation and delivery and the results of peripartum in the two groups. Results The complications of pregnancy,delivery and perinatal infants in elderly group were significantly higher than in non-elderly group. Conclusions The elderly in maternal pregnancy,the incidence of the complications of gestation and delivery was higher,which added the risk during pregnancy and delivery.For ensuring the safety of the pregnant women during perinatal period,and for the sake of the health of mothers and infants,it is significant to pay more attention to gestational and perinatal monitoring,to discover the latent adverse factors early,and to treat in time.
Key words:
Elderly pregnant women ; Pregnancy ; Delivery ; Complication ; Monitoring ;
Cite
Citations (0)
To evaluate multifetal pregnancy reduction as a treatment for patients seeking to reduce the risks of multiple gestation.One hundred thirty-one women had transabdominal multifetal pregnancy reduction performed by a single practitioner; 103 have delivered.Multifetal pregnancy reduction was associated with a 7% pregnancy loss rate and no losses within the first 4 weeks after the procedure. The mean gestational age at delivery overall was 35.5 weeks. The mean gestational age at delivery for singletons was 37.5 weeks, for twins 35.5 weeks, and for triplets 35 weeks. The incidence of maternal and fetal complications was no more than that previously reported for nonreduced multiple gestations.Multifetal pregnancy reduction is a safe option for patients who desire to reduce the risks of multiple gestation. The ultimate successful outcome of reduced pregnancies may be enhanced by extensive experience with the procedure.
Cite
Citations (21)
To estimate whether there is an association between second-trimester cervical length and prolonged pregnancy (defined as delivery at or beyond 41 weeks of gestation).This is a cohort study of nulliparous women with a singleton pregnancy who underwent routine cervical length measurement between 18 and 24 weeks of gestation. Women were divided into quartiles by cervical length and the association with prolonged pregnancy was evaluated in bivariable and multivariable analyses. A planned secondary analysis included only women who achieved at least 39 weeks of gestation.During the study period, a total of 9,165 women met inclusion criteria, of whom 1,481 (16.2%) had a prolonged pregnancy. Women in increasing cervical length quartiles were more likely to experience a prolonged pregnancy (12.9%, 15.8%, 17.1%, 18.6%, P<.001). This association remained significant when controlling for possible confounding variables. An analysis confined to women who achieved at least 39 weeks of gestation was consistent with the overall analysis.Increasing second-trimester cervical length is associated with an increased likelihood of having a prolonged pregnancy in nulliparous women.II.
Quartile
Cite
Citations (6)
Cite
Citations (25)
A 31-year-old woman with a history of stillbirth due to placental abruption at 29 weeks’ gestation and one first trimester miscarriage documented a continuous record of her perceived fetal movements from 28 to 38 weeks’ gestation. Repeated ultrasound examinations confirmed a viable pregnancy, with normal growth, liquor volume and Doppler profile. She delivered a healthy male infant at 38 weeks and 3 days’ gestation. The data collected give a detailed record of fetal activity in a healthy pregnancy. Perceived fetal activity increased as pregnancy progressed and was greatest in the evenings. We also found that clusters of movements, which have previously been reported as protective against stillbirth, were felt earlier on in pregnancy.
Placental abruption
Fetal movement
Cite
Citations (0)
To compare the incidence, severity and pregnancy outcomes of pregnancy induced hypertension in twins and singleton gestations.The cohort study enrolled 305 twins and 298 singleton gestations at Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand between January 1996 and December 2001. The rates of pregnancy induced hypertension and pregnancy outcomes were statistically analysed in both groups. P-value of< 0.05 was considered statistically significant.Pregnancy induced hypertension was found to at develop 18.36% in the twin gestations, compared with 5.03% in the singleton gestations (P < 0.05). Women with twin gestations had higher rates of pregnancy induced hypertension (RR 3.65, 95% CI 2.11-6.30, P<0.05) and occurred earlier than singleton gestations (35.86+/-2.50 VS 37.40+/-1.18 weeks, P<0.05). Twin gestations with pregnancy induced hypertension had significantly higher rate of cesarean delivery, low birthweight, NICU admission and perinatal death than singleton gestations with pregnancy induced hypertension (P< 0.05). Moreover the abruptio placenta, postpartum hemorrhage and perinatal mortality in twin gestations with pregnancy induced hypertension group were significantly higher than in normotensive group (P< 0.05).The incidence of pregnancy induced hypertension was significant higher and occurred earlier with greater adverse pregnancy outcomes among twin gestations than singleton gestations. Moreover, the rate of adverse maternal and perinatal outcomes in twin gestations with pregnancy induced hypertensive group was higher than in normotensive group.
Twin Pregnancy
Gestational hypertension
Cite
Citations (7)