Impact of smoking and fetal gender on preterm delivery

2020 ◽  
pp. 1-6
Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Alexandra Stein ◽  
Nicolai Maass ◽  
Alexander Strauss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Infants ◽  
Preterm Births ◽  
World Health ◽  
Smoking During Pregnancy ◽  
Fetal Gender ◽  
Extremely Preterm ◽  
Heavy Smokers

Abstract According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. We aimed to establish how fetal gender and smoking interact with regard to perinatal outcomes, especially preterm delivery. Data from 220,339 singleton pregnancies, obtained from the German Perinatal Survey in Schleswig-Holstein and registered between 2004 and 2017 were analyzed in regard to smoking behavior, fetal gender, and preterm delivery. The rate of preterm births was directly proportional to the women’s consumption of nicotine. The rate of preterm deliveries was 6.8% among nonsmokers, and 13.2% in women who were very heavy smokers (≥22 cigarettes/day). Very heavy smoking (≥22 cigarettes/day) had a marked impact on extremely preterm births (<28 weeks of gestation) and very preterm births (28–31 weeks of gestation). Preterm births increased by 1.2% from heavy smokers to very heavy smokers; the differences between the other groups ranged between 0.1% and 0.4%. Fetal gender also had an impact on preterm birth: male infants were predominant in nearly all groups of women who delivered preterm infants. Smoking during pregnancy and male gender are both risk factors for preterm delivery. Fetal gender should be given greater attention as one of the several risk factors of preterm birth. Due to the high rate of morbidity among preterm infants and enormous costs for the healthcare system, women should be encouraged to cease or at least reduce smoking during pregnancy.

scholarly journals Preterm birth and sustained inflammation: consequences for the neonate

2020 ◽  
Vol 42 (4) ◽  
pp. 451-468 ◽  
Author(s):  
Alexander Humberg ◽  
◽  
Ingmar Fortmann ◽  
Bastian Siller ◽  
Matthias Volkmar Kopp ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Defense Mechanisms ◽  
Preterm Births ◽  
Immune Defense ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Organ Systems ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Almost half of all preterm births are caused or triggered by an inflammatory process at the feto-maternal interface resulting in preterm labor or rupture of membranes with or without chorioamnionitis (“first inflammatory hit”). Preterm babies have highly vulnerable body surfaces and immature organ systems. They are postnatally confronted with a drastically altered antigen exposure including hospital-specific microbes, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia (“second inflammatory hit”). This is of particular importance to extremely preterm infants born before 28 weeks, as they have not experienced important “third-trimester” adaptation processes to tolerate maternal and self-antigens. Instead of a balanced adaptation to extrauterine life, the delicate co-regulation between immune defense mechanisms and immunosuppression (tolerance) to allow microbiome establishment is therefore often disturbed. Hence, preterm infants are predisposed to sepsis but also to several injurious conditions that can contribute to the onset or perpetuation of sustained inflammation (SI). This is a continuing challenge to clinicians involved in the care of preterm infants, as SI is regarded as a crucial mediator for mortality and the development of morbidities in preterm infants. This review will outline the (i) role of inflammation for short-term consequences of preterm birth and (ii) the effect of SI on organ development and long-term outcome.

scholarly journals Burden and risk factors of preterm birth in Nasarawa State, North Central, Nigeria: A five-year case review

2021 ◽  
Vol 7 (2) ◽  
pp. 36-41
Author(s):  
Ikrama Hassan ◽  
◽  
Surajudeen Bello ◽  
Michael Anazodo ◽  
Abdulmumuni Ahmed Lawal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Preterm Delivery ◽  
Placenta Previa ◽  
Preterm Births ◽  
Cross Sectional Study ◽  
Multiple Gestation ◽  
Case Review ◽  
Premature Rupture ◽  
Cross Sectional

Background: Preterm birth has been on the increase globally and accounting for morbidities and mortalities. Preterm delivery referred to the birth of a newborn prior to thirty seven completed gestational weeks. There is dearth of knowledge on the burden of preterm birth in this state. This study therefore determined the burden of preterm deliveries in Nasarawa State, evaluate the risk factors and identify the outcome of such deliveries. Methods: A descriptive cross-sectional study of all preterm delivered from the 1st of January 2014 to the 31st of December 2013 at the Dalhatu Araf Specialist Hospital (DASH) Lafia, General Hospital Akwanga and Medical Centre Mararaba Gurku in the Southern, Northern and Western senatorial zones of Nasarawa State respectively. Data was analyzed using SPSS version 20. Results: The mean age of mothers of preterm in this study is 26.5±5.7 years. More than three-quarter of preterm birth in Nasarawa State were at the DASH Lafia. The prevalence of preterm birth and admissions were 1.5% and 10.8% respectively. One in four of the preterm were either late preterm or extreme preterm. Singleton gestation accounted for 82.1% of the preterm births while 75.6% of such deliveries where through the vaginal mode of deliveries. Risk factors for preterm deliveries were multiple gestation, antepartum haemorrhage (placenta previa), premature rupture of membrane and previous preterm delivery. Deaths among the preterm was 11% in this study. Conclusion: The burden of preterm births in this study is comparable to other centre in same region. Half of the preterm were either late or extreme preterm. Risk factors for preterm deliveries were placenta previa, premature rupture of membrane, multiple gestation and previous preterm child birth. Death was recorded in one out of every nine preterm

scholarly journals Risk Factors and Outcome of Preterm Labour in Tertiary Health Centre

2020 ◽  
Vol 32 (2) ◽  
pp. 90-93
Author(s):  
Mst Afroza Khanum ◽  
Salma Lavereen ◽  
Moniruzzaman ◽  
Romana
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Labour ◽  
Health Centre ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Vaginal Infection ◽  
History Of

Background: Currently preterm labour is one of the most challenging problems confronting the obstetricians and perinatologists. This unfortunate episode accounts for 50-75% of the perinatal mortality. Methods: A cross sectional study was conducted on 210 pregnant women with preterm labour admitted in Monno Medical College Hospital, Manikganj from June 2014 to December 2015, to study the causes and outcome of preterm birth in Tertiary health centre of Manikganj. Results: Occurence of preterm birth was 13.82%; 47.14% occured between 34-37 weeks of gestation; 33.80% occured 31-33 weeks of gestation and occurred in 28-30 weeks 19.04%. About 22% patients presenting with preterm labour had a past history of abortions and 14.3% had a history of preterm delivery. Premature rupture of membranes was found to be the most common risk factor related with preterm labour in the present pregnancy. Genitourinary tract infection was the next important risk factor of preterm labour; 24.8% (86) patients had either vaginal infection (19.5%) or urinary infection (21.4%) or both. Another important risk factor identified in this study was antepartum haemorrage which was cause in 11.4 % cases. Preterm babies commonly suffered from various complications like jaundice (32.1%), respiratory distress syndrome (22.6%), asphyxia (13.5%), sepsis, hypoglycemia and coagulopathy. Conclusion: Most of the preterm births occured between 34-37 weeks of gestation. Most common risk factors of preterm births are history of abortion and preterm delivery in previous pregnancy; PROM UTI vaginal infection, PIH and APH in correct pregnancy. Newborn jaundice, RDS and birth asphyxia are the common neonatal morbidity in preterm labour. Identifying risk factors to prevent the onset of preterm labour and advanced neonatal care unit can help decrease neonatal morbidity and mortality. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 90-93

NEONATAL OUTCOMES FOLLOWING LATE PRETERM BIRTH

2012 ◽  
Vol 23 (2) ◽  
pp. 97-119 ◽  
Author(s):  
ELAINE M BOYLE
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Infants ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Very Preterm ◽  
Late Preterm Birth ◽  
Extremely Preterm ◽  
Adverse Neonatal Outcomes

It is well recognised that birth before 32 weeks of gestation is associated with substantial neonatal morbidity and mortality and these risks have been extensively reported. The focus of perinatal research for many years has therefore been very preterm and extremely preterm delivery, since the likelihood and severity of adverse neonatal outcomes are highest within this group. In contrast, until recently, more mature preterm infants have been understudied and indeed, almost ignored by researchers.

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

scholarly journals A birth population-based survey of preterm morbidity and mortality by gestational age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojing Guo ◽  
Xiaoqiong Li ◽  
Tingting Qi ◽  
Zhaojun Pan ◽  
Xiaoqin Zhu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Birth Defects ◽  
Gestational Age ◽  
Death Rate ◽  
Preterm Births ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

scholarly journals Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 420
Author(s):  
Claudia Ioana Borțea ◽  
Florina Stoica ◽  
Marioara Boia ◽  
Emil Radu Iacob ◽  
Mihai Dinu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Surfactant Administration ◽  
Stage 1

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

scholarly journals Magnitude of spontaneous preterm birth and its associated factors among preterm birth in NICU wards in Asella Teaching and Referral Hospital, Asella, Oromia, Ethiopia

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110346
Author(s):  
Techane Sisay Tuji ◽  
Addisu Dabi Wake ◽  
Gezahegn Badeg Adere ◽  
Aselefu Beka Wedajo ◽  
Batu Dekeba Obole ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Healthcare Providers ◽  
Preterm Births ◽  
Cross Sectional Study ◽  
Spontaneous Preterm Birth ◽  
Related Factors ◽  
Cross Sectional ◽  
Bivariate Logistic Regression ◽  
Associated Risk Factors

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Bronchopulmonary Dysplasia ◽  
Roc Curve ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

Polymorphisms of haemostasis genes as risk factors for preterm delivery

2005 ◽  
Vol 94 (07) ◽  
pp. 88-92 ◽  
Author(s):  
Christoph Härtel ◽  
Sören von Otte ◽  
Julia Koch ◽  
Peter Ahrens ◽  
Evelyn Kattner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Factor Xiii ◽  
Very Low Birth Weight ◽  
Factor V Leiden ◽  
Factor Vii ◽  
Factor V

SummaryClinical trials evaluating the potential benefit of anticoagulant treatment in pregnant women with inherited thrombophilia are based on the observation that a genetic predisposition to thrombosis is associated with frequent abortions and preterm birth. It was the aim of our study to delineate the impact of genetic polymorphisms with prothrombotic and antithrombotic effects on the occurrence of preterm birth in a large cohort of very-low-birth-weight (VLBW)-infants and their mothers. We examined the factor V Leiden and the prothrombin G20210A mutation, the factor VII 121del/ins and the factor XIII Val34Leu polymorphism in preterm very-low-birth-weight (VLBW, n=593) and term-born-infants (n=278) and their mothers (n=785).The primary outcome was preterm vs. term birth. From all polymorphisms tested, the maternal factor VII-121del/ins polymorphism (26.2 vs. 17.6 %; p=0.009) and the infant’s factor VII-121del/ins polymorphism (29.0 vs. 20.0 %; p=0.009) were more frequent in singletonVLBW and their mothers compared to term infants and their mothers. Furthermore, the frequency of the factor XIII-Val34Leu polymorphism was significantly lower in singleton VLBW than in term infant controls (5.1 vs. 9.6%, p=0.025). In a multivariate regression analysis, previous preterm delivery (OR=3.8, 95% CI: 1.7–8.4), the maternal carrier status of the factor-VII-121del/ins polymorphism (OR=1.7, 95% CI: 1.12–2.5, p=0.007) and the lower frequency of infant’s factor-XIII-Val34Leu polymorphism (OR=0.53; 95% CI: 0.29–0.96; p=0.038) were found to be independently associated with preterm delivery. InVLBW mothers with pathological CTG as cause of preterm delivery, the frequency of factor V Leiden mutation was significantly increased compared to VLBW mothers without pathological CTG (14.1 vs. 6.1%, p=0.01).The investigated haemostasis gene polymorphisms have a much lower impact on subsequent preterm delivery than known risk factors such as previous preterm birth. The reported association of the factor-VII-121del/ins polymorphism on preterm delivery and its clinical relevance needs to be further elucidated.

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