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

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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.

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

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2012.10.633 ◽

2013 ◽

Vol 208 (1) ◽

pp. S203

Author(s):

Amy Turitz ◽

Jamie Bastek ◽

Lisa Levine ◽

Michal Elovitz

Keyword(s):

At Risk ◽

Preterm Birth ◽

Cervical Length ◽

Full Term ◽

Term Birth

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Cost effects of preterm birth: a comparison of health care costs associated with early preterm, late preterm, and full-term birth in the first 3 years after birth

The European Journal of Health Economics ◽

10.1007/s10198-016-0850-x ◽

2016 ◽

Vol 18 (8) ◽

pp. 1041-1046 ◽

Cited By ~ 17

Author(s):

Josephine Jacob ◽

Moritz Lehne ◽

Andrea Mischker ◽

Normen Klinger ◽

Claudia Zickermann ◽

...

Keyword(s):

Health Care ◽

Preterm Birth ◽

Health Care Costs ◽

Full Term ◽

Late Preterm ◽

Term Birth ◽

Care Costs

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The Impact of Previous Obstetric History on the Risk of Spontaneous Preterm Birth in Women with a Sonographic Short Cervix

American Journal of Perinatology ◽

10.1055/s-0040-1705169 ◽

2020 ◽

Vol 37 (12) ◽

pp. 1189-1194

Author(s):

Carolynn M. Dude ◽

Lisa D. Levine ◽

Nadav Schwartz

Keyword(s):

Preterm Birth ◽

Full Term ◽

Secondary Outcome ◽

Spontaneous Preterm Birth ◽

Short Cervix ◽

Term Birth ◽

Obstetric History ◽

Nulliparous Women ◽

History Of ◽

The Impact

Abstract Objective The natural history of women with a short cervix and a low-risk obstetric history remains poorly defined. In our study, we sought to better characterize the impact of previous obstetric history on the delivery outcomes in women diagnosed with a mid-trimester sonographic short cervix. Study Design We performed a retrospective cohort study of women with singleton gestations who underwent transvaginal cervical length screening between 16 and 24 weeks at two urban hospitals in Philadelphia between January 2013 and March 2018 and were found to have a short cervix (defined as ≤2 cm). Women were excluded from the cohort if there were major fetal anomalies noted or if delivery outcome information was not available. The cohort was then divided into three groups based on obstetric history: nulliparous, history of full-term birth only, or history of spontaneous preterm birth (sPTB). The primary outcome was sPTB <37 weeks, while the secondary outcome was sPTB <34 weeks. Results Our cohort included a total of 384 singleton pregnancies that were diagnosed with a sonographic short cervix: 165 women were nulliparous, 119 women had a history of full-term birth, and 100 women with a history of sPTB. We found that women with a short sonographic cervix had a sPTB rate of 39.6% with no differences found between the three groups. Only two-thirds of nulliparous women and women with a history of full-term birth received the recommended preventative treatment, compared with almost 100% of women with a history of sPTB. Conclusion Women with and without a history of sPTB are at comparable risk of sPTB in the presence of a sonographically short cervix. Preventative therapies should be recommended to both nulliparous women and women with a history of full-term birth since uptake in this population are not as high.

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Microorganisms associated with intraamniotic infection among women with preterm birth at Ruhengeri Referral Hospital, Rwanda: A case-control study

10.21203/rs.3.rs-80051/v1 ◽

2020 ◽

Author(s):

Callixte Yadufashije ◽

Jasmine Umugwaneza ◽

Cedrick Izere ◽

Emmanuel Munyeshyaka ◽

Albert Onyango Mala ◽

...

Keyword(s):

Escherichia Coli ◽

Candida Albicans ◽

Preterm Birth ◽

Amniotic Fluid ◽

Full Term ◽

Fetal Membrane ◽

Term Birth ◽

Intraamniotic Infection ◽

Streptococcus Species ◽

Significant Difference

Abstract Background Preterm birth could be a worldwide open well-being danger. It was assessed that each year 15 million neonates are born prematurely around the world, and 40% brought about from intrauterine infections. Methods A total of 40 women were selected. Of the 40 women, 20 had a premature birth, and the remaining 20 had a full-term birth. 120 Swab samples were collected from the placenta, amniotic fluids, and fetal membrane immediately after birth. The sterile cotton swab was used to collect samples and put into swabs Stuart plastic to avoid sample contamination. Samples were transported to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant difference between means of the two groups, while the chi-square test (x2) was used to test for significant association with microorganisms and intraamniotic infections. Results The findings revealed that half of the participants were in the age range of 24–29 years. Non- Albicans Candida (32.7%) and mold (27.9%) were the foremost overwhelming confined microorganisms. Some microorganisms were common to the placenta, amniotic fluid, and fetal membrane. Only Non-Albicans Candida and mold were common to samples of both preterm and full-term women, Staphylococcus species was observed in placental and fetal membrane samples and absented in amniotic fluid. Escherichia coli, Klebsiella species, Streptococcus species, and Candida Albicans were only observed among women with preterm birth. To compare isolated microorganisms between both preterm and full-term birth, the significance test of mean was performed. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P = 0.006522), placental membrane isolates (t = 7.17, P = 0.000372), and fetal membrane isolates (t = 6.7, P = 0.000537). Association with microorganisms and intraamniotic infection was statistically significant with Escherichia coli (x2 = 3.98, P = 0.046044), Streptococcus species (x2 = 5.53, P = 0.018693), Yeast (x2 = 8.37, P = 0.003815) and Candida Albicans (x2 = 3.98, P = 0.046044). Conclusion Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.

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SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1143 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Monika Kushwaha ◽

Sanjeev Narang

Keyword(s):

Preterm Birth ◽

Comparative Study ◽

Pregnancy Outcome ◽

Neonatal Morbidity ◽

Research Centre ◽

College Hospital ◽

Cross Sectional ◽

Chorionic Villi ◽

Term Birth ◽

Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

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The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062951 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2951

Author(s):

Ju Sun Heo ◽

Jiwon M. Lee

Keyword(s):

Renal Function ◽

Preterm Birth ◽

Glomerular Filtration ◽

Renal Plasma Flow ◽

Meta Analysis ◽

Full Term ◽

Significant Difference ◽

Preterm Group ◽

Preterm Born

The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate.

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Telomeres and replicative cellular aging of the human placenta and chorioamniotic membranes

Scientific Reports ◽

10.1038/s41598-021-84728-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tsung-Po Lai ◽

Mark Simpson ◽

Krunal Patel ◽

Simon Verhulst ◽

Jungsik Noh ◽

...

Keyword(s):

Dna Damage ◽

Preterm Birth ◽

Telomere Length ◽

Human Placenta ◽

Replicative Senescence ◽

Preterm Births ◽

Full Term ◽

Cellular Aging ◽

Telomere Dysfunction ◽

Replicative Aging

AbstractRecent hypotheses propose that the human placenta and chorioamniotic membranes (CAMs) experience telomere length (TL)-mediated senescence. These hypotheses are based on mean TL (mTL) measurements, but replicative senescence is triggered by short and dysfunctional telomeres, not mTL. We measured short telomeres by a vanguard method, the Telomere shortest length assay, and telomere-dysfunction-induced DNA damage foci (TIF) in placentas and CAMs between 18-week gestation and at full-term. Both the placenta and CAMs showed a buildup of short telomeres and TIFs, but not shortening of mTL from 18-weeks to full-term. In the placenta, TIFs correlated with short telomeres but not mTL. CAMs of preterm birth pregnancies with intra-amniotic infection showed shorter mTL and increased proportions of short telomeres. We conclude that the placenta and probably the CAMs undergo TL-mediated replicative aging. Further research is warranted whether TL-mediated replicative aging plays a role in all preterm births.

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Validity of pre and post-term birth rates based on the date of last menstrual period compared to early obstetric ultrasonography

Cadernos de Saúde Pública ◽

10.1590/0102-311x00121514 ◽

2015 ◽

Vol 31 (4) ◽

pp. 885-890 ◽

Cited By ~ 2

Author(s):

Maria Nilza Lima Medeiros ◽

Nádia Carenina Nunes Cavalcante ◽

Fabrício José Alencar Mesquita ◽

Rosângela Lucena Fernandes Batista ◽

Vanda Maria Ferreira Simões ◽

...

Keyword(s):

Preterm Birth ◽

Positive Predictive Value ◽

Predictive Value ◽

Birth Rate ◽

Menstrual Period ◽

Last Menstrual Period ◽

Birth Rates ◽

Term Birth ◽

Preterm Birth Rate ◽

Obstetric Ultrasonography

The aim of this study was to assess the validity of the last menstrual period (LMP) estimate in determining pre and post-term birth rates, in a prenatal cohort from two Brazilian cities, São Luís and Ribeirão Preto. Pregnant women with a single fetus and less than 20 weeks' gestation by obstetric ultrasonography who received prenatal care in 2010 and 2011 were included. The LMP was obtained on two occasions (at 22-25 weeks gestation and after birth). The sensitivity of LMP obtained prenatally to estimate the preterm birth rate was 65.6% in São Luís and 78.7% in Ribeirão Preto and the positive predictive value was 57.3% in São Luís and 73.3% in Ribeirão Preto. LMP errors in identifying preterm birth were lower in the more developed city, Ribeirão Preto. The sensitivity and positive predictive value of LMP for the estimate of the post-term birth rate was very low and tended to overestimate it. LMP can be used with some errors to identify the preterm birth rate when obstetric ultrasonography is not available, but is not suitable for predicting post-term birth.

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