467: Prior full term birth reduces risk of short cervical length in women at risk for preterm birth

Background: Preterm Birth (PTB) is one of the main causes of neonatal death and infant mortality and morbidity. The pro-inflammatory cytokine interleukin-6 (IL-6) is a major proinflammatory mediator of the host response to infection and malondialdehyde (MDA) is a marker of oxidative stress. Objective : To evaluate potential associations between IL-6 and MDA levels in women with preterm birth. Method: A total of 150 women (66 with full-term and 84 with PTB) were enrolled in this case-control study. Predesigned performas were filled through questionnaire interviews to collect data on personal, demographic, occupational, lifestyle and reproductive history. Blood samples were collected within 36 hours of delivery. Serum concentrations of IL-6 and MDA were determined in mothers with full-term and preterm birth. Results: The mean age was marginally higher; whereas BMI was slightly lower in cases (PTB) as compared to controls (full-term) subjects. Serum IL-6 and MDA levels were significantly higher in subjects with PTB than full-term birth. The data were further analyzed with respect to underweight, normal and overweight/obese BMI. In all the BMI categories, the levels of IL-6 and MDA were higher in PTB cases. Among the PTB categories, the levels of IL-6 and MDA were highest in moderate to late preterm birth. A significant positive correlation was found between IL-6 and MDA levels. There was a weak negative correlation between either IL-6 or MDA and the number of gestational weeks. Conclusion : Elevated maternal serum levels of Interleukin-6 and Malondialdehyde in preterm as compared to full-term birth might suggest that inflammation and oxidative stress play a critical role in PTB.

Download Full-text

Cervical Length in the Early Second Trimester for Detection of Triplet Pregnancies at Risk for Preterm Birth

Journal of Ultrasound in Medicine ◽

10.7863/jum.2004.23.9.1187 ◽

2004 ◽

Vol 23 (9) ◽

pp. 1187-1191 ◽

Cited By ~ 13

Author(s):

Sharon Maslovitz ◽

Joseph Hartoov ◽

Igal Wolman ◽

Ariel Jaffa ◽

Joseph B. Lessing ◽

...

Keyword(s):

At Risk ◽

Preterm Birth ◽

Cervical Length ◽

Second Trimester

Download Full-text

Prediction of Spontaneous Preterm Birth in At-risk Women Using Thrombospondin 1 from Cervicovaginal Fluid: A Prospective Observational Study

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1486-7148 ◽

2021 ◽

Vol 81 (09) ◽

pp. 1055-1064

Author(s):

Johannes Stubert ◽

Kathleen Gründler ◽

Bernd Gerber ◽

Dagmar-Ulrike Richter ◽

Max Dieterich

Keyword(s):

At Risk ◽

Preterm Birth ◽

Predictive Value ◽

Transvaginal Ultrasound ◽

Area Under The Curve ◽

Cervical Length ◽

Multiple Gestation ◽

Spontaneous Preterm Birth ◽

Thrombospondin 1 ◽

Cervicovaginal Fluid

Abstract Introduction Thrombospondin 1, desmoplakin and stratifin are putative biomarkers for the prediction of preterm birth. This study aimed to validate the predictive capability of these biomarkers in patients at risk of preterm birth. Materials and Methods We included 109 women with symptoms of threatened spontaneous preterm birth between weeks 20 0/7 and 31 6/7 of gestation. Inclusion criteria were uterine contractions, cervical length of less than 25 mm, or a personal history of spontaneous preterm birth. Multiple gestations were also included. Samples of cervicovaginal fluid were taken before performing a digital examination and transvaginal ultrasound. Levels of cervicovaginal thrombospondin 1, desmoplakin and stratifin were quantified by enzyme-linked immunosorbent assays. The primary endpoint was spontaneous preterm birth before 34 + 0 weeks of gestation. Results Sixteen women (14.7%) delivered before 34 + 0 weeks. Median levels of thrombospondin 1 were higher in samples where birth occurred before 34 weeks vs. ≥ 34 weeks of gestation (4904 vs. 469 pg/mL, p < 0.001). Receiver operator characteristics analysis resulted in an area under the curve of 0.86 (p < 0.0001). At an optimal cut-off value of 2163 pg/mL, sensitivity, specificity, positive predictive value and negative predictive value were 0.94, 0.77, 0.42 and 0.99, respectively, with an adjusted odds ratio of 32.9 (95% CI: 3.1 – 345, p = 0.004). Multiple gestation, cervical length, and preterm labor had no impact on the results. Survival analysis revealed a predictive period of more than eight weeks. Levels of desmoplakin and stratifin did not differ between groups. Conclusion Thrombospondin 1 allowed long-term risk estimation of spontaneous preterm birth.

Download Full-text

Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/j.yobg.2011.05.162 ◽

2011 ◽

Vol 2011 ◽

pp. 140-141

Author(s):

L.P. Shulman

Keyword(s):

At Risk ◽

Preterm Birth ◽

Bacterial Vaginosis ◽

Cervical Length

Download Full-text

239: Among women at risk for recurrent preterm birth, is there a cervical length cut-point, above 15mm, that predicts eventual cerclage recommendation?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2016.11.144 ◽

2017 ◽

Vol 216 (1) ◽

pp. S149-S150

Author(s):

Soha S. Patel ◽

Amy L. Turitz ◽

Jamie A. Bastek ◽

Michal A. Elovitz ◽

Lisa D. Levine

Keyword(s):

At Risk ◽

Preterm Birth ◽

Cervical Length ◽

Cut Point

Download Full-text

875: Prior full term birth does not decrease the risk of recurrent preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2014.10.1081 ◽

2015 ◽

Vol 212 (1) ◽

pp. S417

Author(s):

Stephanie Purisch ◽

Michal Elovitz ◽

Amy Turitz ◽

Lisa Levine

Keyword(s):

Preterm Birth ◽

Full Term ◽

Term Birth

Download Full-text

Maternal obesity classes, preterm and post-term birth: a retrospective analysis of 479,864 births in England

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2585-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Emma Slack ◽

Kate E. Best ◽

Judith Rankin ◽

Nicola Heslehurst

Keyword(s):

Preterm Birth ◽

Retrospective Analysis ◽

Gestational Age ◽

Maternal Obesity ◽

Absolute Risk ◽

Full Term ◽

Effect Sizes ◽

Term Birth ◽

Gestational Age At Delivery ◽

Maternal Bmi

Abstract Background Preterm (< 37 weeks gestation) and post–term birth (≥42 weeks gestation) are associated with increased morbidity and mortality for mother and infant. Obesity (body mass index (BMI) ≥30 kg/m2) is increasing in women of reproductive age. Maternal obesity has been associated with adverse pregnancy outcomes including preterm and post–term birth. However, the effect sizes vary according to the subgroups of both maternal BMI and gestational age considered. The aim of this retrospective analysis was to determine the association between maternal obesity classes and gestational age at delivery. Methods A secondary data analysis of 13 maternity units in England with information on 479,864 singleton live births between 1990 and 2007. BMI categories were: underweight (< 18.5 kg/m2), recommended weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obesity classes I (30.0–34.9 kg/m2), II (35.0–39.9 kg/m2), IIIa (40–49.9 kg/m2) and IIIb (≥50 kg/m2). Gestational age at delivery categories were: Gestational age at delivery (weeks): extreme preterm (20–27), very preterm (28–31), moderately preterm (32–36), early term (37, 38), full term (39–40), late term (41) and post–term (≥42). The adjusted odds of births in each gestational age category (compared to full-term birth), according to maternal BMI categories were estimated using multinomial logistic regression. Missing data were estimated using multiple imputation with chained equations. Results There was a J-shaped association between the absolute risk of extreme, very and moderate preterm birth and BMI category, with the greatest effect size for extreme preterm. The absolute risk of post-term birth increased monotonically as BMI category increased. The largest effect sizes were observed for class IIIb obesity and extreme preterm birth (adjusted OR 2.80, 95% CI 1.31–5.98). Conclusion Women with class IIIb obesity have the greatest risks for inadequate gestational age. Combining obesity classes does not accurately represent risks for many women as it overestimates the risk of all preterm and post-term categories for women with class I obesity, and underestimates the risk for women in all other obesity classes.

Download Full-text