Second stage cesarean as risk factor for preterm birth: how to manage subsequent pregnancies?

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.

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Response: Preterm Birth - Another Risk Factor for Renal and Cardiovascular Diseases in Later Life ?

Klinische Pädiatrie ◽

10.1055/s-0031-1275294 ◽

2011 ◽

Vol 223 (02) ◽

pp. 95-95

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Cardiovascular Diseases ◽

Later Life

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Association of the polymorphism 12109g>A from the REN gene as a risk factor for preterm birth

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320316678159 ◽

2016 ◽

Vol 17 (4) ◽

pp. 147032031667815 ◽

Cited By ~ 1

Author(s):

Irám P Rodríguez-Sánchez ◽

Stephania Suárez-Caro ◽

Fernando Rivas-Solís ◽

Iván Delgado-Enciso ◽

María M Sánchez-Chaparro ◽

...

Keyword(s):

Risk Factor ◽

Preterm Birth

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Cross-Generational Contributors to Preterm Birth in California: Singletons Based on Race/Ethnicity

American Journal of Perinatology ◽

10.1055/s-0038-1668554 ◽

2018 ◽

Vol 36 (04) ◽

pp. 383-392

Author(s):

Juan Yang ◽

Rebecca Baer ◽

Paul Chung ◽

Laura Jelliffe-Pawlowski ◽

Tumaini Coker ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Preterm Birth ◽

Preterm Delivery ◽

Clinical Characteristics ◽

Birth Registry ◽

Live Births ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic

Objective Multiple studies have examined cross-generational patterns of preterm birth (PTB), yet results have been inconsistent and generally focused on primarily white populations. We examine the cross-generational PTB risk across racial/ethnic groups. Study Design Retrospective study of 388,474 grandmother–mother–infant triads with infants drawn from birth registry of singleton live births between 2005 and 2011 in California. Using logistic regression (odds ratios [ORs] and confidence intervals [CIs]), we examined the risk of preterm delivery by gestational age, sociodemographic, socioeconomic, and obstetric clinical characteristics stratified by maternal race/ethnicity. Results The risk of having a preterm infant <32 weeks was greater for women born at <32 weeks (OR: 2.09, 95% CI: 1.62–2.70) and 32 to 36 weeks (OR: 1.51, 95% CI: 1.35–1.70). This increased risk of preterm delivery was present among women in all race/ethnicity groups (white [AOR: 2.00, 95% CI: 1.52–2.63), black [AOR: 1.79, 95% CI: 1.37–2.34], Hispanic [AOR: 2.39, 95% CI: 2.05–2.79], and Asian [AOR: 2.12, 95% CI: 1.20–3.91]), with hypertension as the only consistent risk factor associated with increased risk of preterm delivery. Conclusion Our findings suggest a cross-generational risk of PTB that is consistent across race/ethnicity with hypertension as the only consistent risk factor.

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Pregnancy Complicated With Hepatitis B Virus Infection and Preterm Birth: A Retrospective Cohort Study

10.21203/rs.3.rs-152431/v1 ◽

2021 ◽

Author(s):

Shuisen Zheng ◽

Huale Zhang ◽

Rongxin Chen ◽

Jianying Yan ◽

Qing Han

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnant Women ◽

Hbv Infection ◽

Confounding Factors ◽

Logistics Regression ◽

Chronic Hepatitis B Virus ◽

B Virus

Abstract Background: We aimed to investigate whether maternal chronic hepatitis B virus (HBV) infection affects preterm birth（PTB) in pregnant women. Methods: We retrospectively analyzed HBV-infected and non-infected pregnant women attending antenatal care at Fujian Provincial Maternity and Child Health Hospital, Fuzhou, China between January 1, 2016 to December 31, 2018. Participants were divided into HBV infection (n = 1302) and control (n = 12813) groups. We compared baseline data, pregnancy and perinatal complications, and preterm delivery outcomes between groups and performed subgroup comparisons and multiple logistics regression analysis to adjust for confounding factors. Results: The incidence of PTBs before 37 weeks was similar between the groups. PTBs before 34 weeks were significantly more among the HBV infection group than among the controls (1.6% VS. 0.8% ; P = 0.003) After adjusting for confounding factors through logistics regression, HBV infection was found to be an independent PTB risk factor before 34 weeks gestation (adjusted odds ratio 1.796; 95% confidence interval[1.071, 3.012]). According to the subgroup analysis based on whether hepatitis B e-antigen (HBeAg) was positive and whether alanine aminotransferase (ALT) levels were normal during the second trimester, PTB was more frequent in HBeAg negative HBV infection before 34 weeks than among controls(1.8% VS. 0.8%). The PTB rate for pregnant women with normal ALT and HBV infection before 34 weeks was higher than that of the controls (1.6% VS. 0.8%) Conclusion HBV infection is an independent risk factor for PTB before 34 weeks. Comprehensive programs focusing on pregnant women with HBV infection would reduce the incidence of adverse outcomes.

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Abstract 08: Preterm Delivery and Maternal Cardiovascular Risk Factor Trajectories across the Life Course

Circulation ◽

10.1161/circ.135.suppl_1.08 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Amanda R Markovitz ◽

Eirin B Haug ◽

Julie Horn ◽

Abigail Fraser ◽

Corrie Macdonald-Wallis ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Preterm Birth ◽

Life Course ◽

Preterm Delivery ◽

First Birth ◽

Birth Registry ◽

Hs Crp ◽

The Life Course

Introduction: Preterm delivery (<37 weeks) predicts 2 to 3-fold greater risk of cardiovascular disease in mothers. Development of subclinical cardiovascular risk in these women prior to and following pregnancy is not well understood. Hypothesis: Women who deliver preterm have an adverse cardiovascular health profile even prior to pregnancy. Methods: Linked data from the population-based, longitudinal HUNT study (1984-2008) and the Medical Birth Registry of Norway (1967-2012) yielded clinical measurements and pregnancy outcomes for 23,179 parous women. Women had up to 3 measurements of body mass index, waist circumference, blood pressure, non-fasting lipids and glucose, and high-sensitivity C-reactive protein (hs-CRP) during a follow-up period between 20 years before first birth to 41 years after first birth. We used mixed effects linear spline models, adjusting for age, pre-pregnancy smoking, education, and time since last meal, to compare risk factor trajectories for women with preterm versus term/postterm first births. Results: Women with a preterm first birth (n=1,402, 6%) had significantly higher triglyceride (Figure 1 A) and glucose levels prior to pregnancy. They also experienced steeper increases in systolic and diastolic blood pressure, non-HDL cholesterol, triglycerides, and hs-CRP from first birth to age 50 compared to women who delivered at term/post-term (Figure 1 A,B). Measures of adiposity were similar throughout the life course. Conclusions: These results are consistent with the hypothesis that preterm birth is an early marker of cardiometabolic impairment. A history of preterm birth may predict high cardiovascular risk well before the development of traditional risk factors.

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