Lifestyle Intervention and Prevention of Spontaneous Preterm Delivery in Obese Pregnant Women

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions. In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups.

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Associations between second-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α and spontaneous preterm delivery in singleton pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0297 ◽

2019 ◽

Vol 47 (3) ◽

pp. 304-310 ◽

Cited By ~ 5

Author(s):

Rauf Melekoglu ◽

Ercan Yilmaz ◽

Osman Ciftci ◽

Yusuf Taner Kafadar ◽

Ebru Celik

Keyword(s):

Preterm Birth ◽

Amniotic Fluid ◽

Pregnant Women ◽

Preterm Delivery ◽

Control Group ◽

Second Trimester ◽

Spontaneous Preterm Delivery ◽

Tnf Α ◽

Factor Α ◽

Fluid Levels

Abstract Background We investigated the roles of inflammatory cytokines and the A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) family in the etiopathogenesis of spontaneous preterm delivery by comparing the ADAMTS4, ADAMTS5, interleukin (IL)-6, and tumor necrosis factor-α (TNF-α) levels in second-trimester amniotic fluid between pregnant women with preterm birth and term controls. Methods All pregnant women who underwent second-trimester amniocentesis for genetic analysis between January 1, 2016, and January 1, 2018, were enrolled in this study. From this cohort, 22 patients who subsequently experienced spontaneous preterm delivery before 34 weeks of pregnancy formed the study group, and 22 age- and body mass index (BMI)-matched patients without preterm birth constituted the control group. Results No significant differences were observed between the preterm birth and control groups in terms of age, BMI, obstetric history of preterm delivery, gestational age at amniocentesis, or indication for amniocentesis. The mean amniotic fluid levels of ADAMTS4 and ADAMTS5 were significantly increased in the preterm birth group compared to the control group (248.3±22.6 and 182.4±19.8 pg/mL, P=0.012; and 198.6±21.6 and 159.1±21.7 pg/mL, P=0.035, respectively). Significantly increased IL-6 and TNF-α levels were also detected in the amniotic fluid of women who experienced spontaneous preterm delivery, relative to controls (142.1±16.2 and 95.8±16.4 pg/mL, P<0.001; and 139.4±12.5 and 89.6±11.2 pg/mL, P<0.001, respectively). Conclusion The results of this study imply that increased mid-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α play an important role in the pathophysiology of spontaneous preterm delivery.

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Prediction of neonatal morbidity and very preterm delivery using maternal steroid biomarkers in early gestation

PLoS ONE ◽

10.1371/journal.pone.0243585 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0243585

Author(s):

Avinash S. Patil ◽

Chad A. Grotegut ◽

Nilesh W. Gaikwad ◽

Shelley D. Dowden ◽

David M. Haas

Keyword(s):

Length Of Stay ◽

Pregnant Women ◽

Preterm Delivery ◽

Neonatal Morbidity ◽

Fetal Sex ◽

Early Gestation ◽

Patient Demographic ◽

Very Preterm ◽

Spontaneous Preterm Delivery ◽

Progesterone Metabolites

Background Preterm delivery is a common pregnancy complication that can result in significant neonatal morbidity and mortality. Limited tools exist to predict preterm birth, and none to predict neonatal morbidity, from early in pregnancy. The objective of this study was to determine if the progesterone metabolites 11-deoxycorticosterone (DOC) and 16-alpha hydroxyprogesterone (16α-OHP), when combined with patient demographic and obstetric history known during the pregnancy, are predictive of preterm delivery-associated neonatal morbidity, neonatal length of stay, and risk for spontaneous preterm delivery prior to 32 weeks’ gestation. Methods and findings We conducted a cohort study of pregnant women with plasma samples collected as part of Building Blocks of Pregnancy Biobank at the Indiana University School of Medicine. The progesterone metabolites, DOC and 16α-OHP, were quantified by mass spectroscopy from the plasma of 58 pregnant women collected in the late first trimester/early second trimester. Steroid levels were combined with patient demographic and obstetric history data in multivariable logistic regression models. The primary outcome was composite neonatal morbidity as measured by the Hassan scale. Secondary outcomes included neonatal length of stay and spontaneous preterm delivery prior to 32 weeks’ gestation. The final neonatal morbidity model, which incorporated antenatal corticosteroid exposure and fetal sex, was able to predict high morbidity (Hassan score ≥ 2) with an area under the ROC curve (AUROC) of 0.975 (95% CI 0.932, 1.00), while the model without corticosteroid and fetal sex predictors demonstrated an AUROC of 0.927 (95% CI 0.824, 1.00). The Hassan score was highly correlated with neonatal length of stay (p<0.001), allowing the neonatal morbidity model to also predict increased neonatal length of stay (53 [IQR 22, 76] days vs. 4.5 [2, 31] days, above and below the model cut point, respectively; p = 0.0017). Spontaneous preterm delivery prior to 32 weeks’ gestation was also predicted with an AUROC of 0.94 (95% CI 0.869, 1.00). Conclusions Plasma levels of DOC and 16α-OHP in early gestation can be combined with patient demographic and clinical data to predict significant neonatal morbidity, neonatal length of stay, and risk for very preterm delivery, though validation studies are needed to verify these findings. Early identification of pregnancies at risk for preterm delivery and neonatal morbidity allows for timely implementation of multidisciplinary care to improve perinatal outcomes.

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Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0382 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 16

Author(s):

Edgar Hernandez-Andrade ◽

Maynor Garcia ◽

Hyunyoung Ahn ◽

Steven J. Korzeniewski ◽

Homam Saker ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Preterm Delivery ◽

Sagittal Plane ◽

Cross Sectional ◽

Spontaneous Preterm Delivery ◽

The Cross ◽

Singleton Pregnancies

AbstractTo evaluate the association between cervical strain assessed with quasi-static elastography and spontaneous preterm delivery.Quasi-static elastography was used to estimate cervical strain in 545 pregnant women with singleton pregnancies from 11 weeks to 28 weeks of gestation. Cervical strain was evaluated in one sagittal plane and in the cross-sectional planes of the internal cervical os and external cervical os. The distribution of strain values was categorized into quartiles for each studied region and their association with spontaneous preterm delivery at ≤34 weeks and at <37 weeks of gestation was evaluated using logistic regression.The prevalence of spontaneous preterm delivery at <37 weeks of gestation was 8.2% (n=45), and that at ≤34 weeks of gestation was 3.8% (n=21). Strain in the internal cervical os was the only elastography value associated with spontaneous preterm delivery. Women with strain values in the 3Increased strain in the internal cervical os is associated with higher risk of spontaneous preterm delivery both at ≤34 and <37 weeks of gestation.

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Cervical length at 23 weeks in twins in predicting spontaneous preterm delivery

Obstetrics and Gynecology ◽

10.1016/s0029-7844(99)00277-x ◽

1999 ◽

Vol 94 (3) ◽

pp. 450-454 ◽

Cited By ~ 52

Author(s):

A Souka

Keyword(s):

Preterm Delivery ◽

Cervical Length ◽

Spontaneous Preterm Delivery

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Faculty Opinions recommendation of Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1280988.746106 ◽

2009 ◽

Author(s):

Marleen van Baak

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Weight Gain ◽

Pregnant Women ◽

Lifestyle Intervention ◽

Gestational Weight Gain ◽

Dietary Habits ◽

Controlled Trial ◽

Gestational Weight ◽

Randomized Controlled

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Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

Twin Research and Human Genetics ◽

10.1375/twin.11.5.552 ◽

2008 ◽

Vol 11 (5) ◽

pp. 552-557 ◽

Cited By ~ 20

Author(s):

Katharina Klein ◽

Hubertus Gregor ◽

Kora Hirtenlehner-Ferber ◽

Maria Stammler-Safar ◽

Armin Witt ◽

...

Keyword(s):

Preterm Delivery ◽

Smoking Habit ◽

Cervical Length ◽

Spontaneous Preterm Delivery ◽

Spontaneous Labour ◽

High Incidence ◽

High Cervical ◽

Twin Pregnancies ◽

Preterm Rupture Of Membranes ◽

Spontaneous Delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

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