Cesarean in the second stage: a possible risk factor for subsequent spontaneous preterm birth

Abstract Background: Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of labor dystocia in histological chorioamnionitis and funisitis has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis.Methods: In this retrospective cohort study, the patients who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was graded as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2.Result: Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9-20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7-21.8), funisitis (adjusted odds ratio, 9.4; 95% confidence interval, 1.8-48.2), and funisitis stage ≥2 (adjusted odds ratio, 23.5; 95% confidence interval, 2.3-23.8). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7-7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.9), and funisitis (adjusted odds ratio, 4.5; 95% confidence interval, 1.2-16.8). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion: Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

Download Full-text

Prolonged second stage of labor and risk of subsequent spontaneous preterm birth

American Journal of Obstetrics & Gynecology MFM ◽

10.1016/j.ajogmf.2020.100093 ◽

2020 ◽

Vol 2 (2) ◽

pp. 100093

Author(s):

Nasim C. Sobhani ◽

Arianna G. Cassidy ◽

Marya G. Zlatnik ◽

Melissa G. Rosenstein

Keyword(s):

Preterm Birth ◽

Spontaneous Preterm Birth ◽

Second Stage Of Labor ◽

Second Stage

Download Full-text

674: Family history of spontaneous preterm birth (sPTB) among siblings and across two generations is a risk factor for preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.11.204 ◽

2018 ◽

Vol 218 (1) ◽

pp. S405-S406

Author(s):

Amanda Koire ◽

Derrick Chu ◽

Kjersti Aagaard

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Family History ◽

Spontaneous Preterm Birth ◽

Two Generations ◽

History Of

Download Full-text

Prolonged Second Stage in the First Pregnancy and Risk of Subsequent Spontaneous Preterm Birth [30R]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000559163.60235.54 ◽

2019 ◽

Vol 133 (1) ◽

pp. 199S-199S

Author(s):

Nasim C. Sobhani ◽

Arianna G. Cassidy ◽

Melissa G. Rosenstein ◽

Marya G. Zlatnik

Keyword(s):

Preterm Birth ◽

Spontaneous Preterm Birth ◽

Second Stage

Download Full-text

Duration of the second stage of labor and risk of subsequent spontaneous preterm birth

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.17102 ◽

2022 ◽

Author(s):

Geffen Kleinstern ◽

Roy Zigron ◽

Shay Porat ◽

Joshua I. Rosenbloom ◽

Misgav Rottenstreich ◽

...

Keyword(s):

Preterm Birth ◽

Spontaneous Preterm Birth ◽

Second Stage Of Labor ◽

Second Stage

Download Full-text

Labor dystocia and risk of histological chorioamnionitis and funisitis: a study from a single tertiary referral center

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03719-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hyo Kyozuka ◽

Tuyoshi Murata ◽

Toma Fukuda ◽

Erina Suzuki ◽

Riho Yazawa ◽

...

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Confidence Interval ◽

Umbilical Cord ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Neonatal Outcomes ◽

Spontaneous Preterm Birth ◽

Labor Dystocia

Abstract Background Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of histological chorioamnionitis and funisitis of labor dystocia has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis. Methods In this retrospective cohort study, the cases who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was staged as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2. Result Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9–20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7–21.8), funisitis (adjusted odds ratio, 15.4; 95% confidence interval, 2.3–101.3), and funisitis stage ≥2 (adjusted odds ratio, 18.5; 95% confidence interval, 2.5–134.0). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7–7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2–7.9), and funisitis (adjusted odds ratio, 6.6; 95% confidence interval, 1.4–30.6). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

Download Full-text

Genital mycoplasma infection and spontaneous preterm birth outcome: a prospective cohort study

10.22541/au.162497149.94552445/v1 ◽

2021 ◽

Author(s):

Giulia Cunha ◽

Larissa Bastos ◽

Stella Freitas ◽

Ricardo Cavalli ◽

Silvana Quintana

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Bacterial Vaginosis ◽

Prospective Cohort ◽

Previous History ◽

Cervical Length ◽

Mycoplasma Infection ◽

Spontaneous Preterm Birth ◽

History Of ◽

Tract Infections

Objective To determine the prevalence of genital mycoplasma infection and the risk of spontaneous preterm birth (sPTB) in asymptomatic pregnant women. Design Prospective cohort. Setting Public and private health services in Ribeirão Preto-SP, Brazil. Population 1.349 asymptomatic women with a singleton pregnancy at 20-25 weeks of gestation (WG) recruited between 2010 and 2011. Methods Baseline data was assessed using a questionnaire, in addition to cervicovaginal fluid and blood samples, to analyze lower reproductive tract infections (RTIs) and immune mediators, respectively. The association between variables and the risk of sPTB was evaluated using logistic regression analysis to estimate the odds ratios (ORs). Main outcome measures Genital mycoplasma infection and prematurity. Results The prevalence of the sPTB and genital mycoplasma was 6.8% and 18%, respectively. The infection was not a risk factor for sPTB (aOR 0.66; 95% CI 0.32-1.35), even when associated with bacterial vaginosis (BV). However, it was associated with a low socioeconomic status (p=0.0470), cigarette use (p=0.0009), number of sexual partners (p=0.0019), and BV (p<.0001). Regarding the risk factors associated with sPTB, previous history of PTB (aOR 12.06; 95% CI 6.21-23.43) and a cervical length ≤ 2.5 cm (aOR 3.97; 95% CI 1.67-9.47) were significant. Conclusions The risk of sPTB was independently associated with the history of PTB and the cervical length but not with the genital mycoplasma infection. Funding: This work was founded by CNPq, FAPESP and CAPES. Keywords: Preterm birth, pregnancy, genital mycoplasma, bacterial vaginosis, risk factor

Download Full-text

Corrigendum to “Is IVF/ICSI an Independent Risk Factor for Spontaneous Preterm Birth in Singletons? A Population-Based Cohort Study”

BioMed Research International ◽

10.1155/2019/4940314 ◽

2019 ◽

Vol 2019 ◽

pp. 1-1

Author(s):

Nina Jančar ◽

Barbara Mihevc Ponikvar ◽

Sonja Tomšič ◽

Eda Vrtačnik Bokal ◽

Sara Korošec

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Preterm Birth ◽

Independent Risk Factor ◽

Population Based ◽

Spontaneous Preterm Birth

Download Full-text

618Is mode of first birth a risk factor for subsequent preterm birth?

International Journal of Epidemiology ◽

10.1093/ije/dyab168.301 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Jessica Gugusheff ◽

Jillian Patterson ◽

Siranda Torvaldsen ◽

Ibinabo Ibiebele ◽

Tanya Nippita

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Lower Risk ◽

Regression Models ◽

Strong Predictor ◽

Population Based ◽

Linkage Study ◽

Term Pregnancy ◽

Spontaneous Preterm Birth ◽

First Birth

Abstract Background Previous preterm birth is a strong predictor of subsequent preterm birth but less is known about the causes of preterm birth following a full-term pregnancy. Recent research highlighted previous caesarean as a potential risk factor and we aimed to further explore this risk. Methods This population-based record linkage study included all women in NSW, Australia who had a live singleton first birth at ≥ 37 weeks gestation, followed by a singleton second birth between 2005–2017. Relative risk (RR) and 95%CI of having a subsequent preterm birth, spontaneous preterm birth or preterm pre-labour caesarean was calculated using individual modified Poisson regression models, with mode of first birth as the exposure. Results Women who had an intrapartum (RR:1.26, 95%CI 1.19–1.32) or prelabour caesarean (RR:1.26,95%CI 1.18–1.35) first birth had a higher risk of subsequent preterm birth, than those who birthed vaginally. Those who had a pre-labour caesarean (RR:0.74, 95%CI 0.67–0.82) had a lower risk of subsequent spontaneous preterm birth. However, prior pre-labour caesarean also greatly increased the risk of subsequent preterm prelabour caesarean (RR:5.25, 95%CI 4.65–5.93). Conclusions Pre-labour and intrapartum caesareans have differing effects on the risk of subsequent spontaneous preterm birth and preterm pre-labour caesarean. Key messages The risk of subsequent preterm birth following a first birth caesarean depends on whether the caesarean occurred before or after the onset of labour and whether the subsequent preterm birth is spontaneous or a pre-labour caesarean.

Download Full-text