Are reported preterm birth rates reliable? An analysis of interhospital differences in the calculation of the weeks of gestation at delivery and preterm birth rate

2004 ◽  
Vol 111 (2) ◽  
pp. 160-163 ◽  
Author(s):  
Imelda Balchin ◽  
John C. Whittaker ◽  
Philip J. Steer ◽  
Ronald F. Lamont
2015 ◽  
Vol 31 (4) ◽  
pp. 885-890 ◽  
Author(s):  
Maria Nilza Lima Medeiros ◽  
Nádia Carenina Nunes Cavalcante ◽  
Fabrício José Alencar Mesquita ◽  
Rosângela Lucena Fernandes Batista ◽  
Vanda Maria Ferreira Simões ◽  
...  

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.


2022 ◽  
Author(s):  
Joyce Martin ◽  
Michelle Osterman

This report is limited to singleton births and describes trends in preterm birth rates from 2014 through 2020 and changes in rates between 2019 and 2020 by maternal race and Hispanic origin, age, and state of residence.


2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Miha Lucovnik ◽  
Andreja Trojner Bregar ◽  
Lili Steblovnik ◽  
Ivan Verdenik ◽  
Ksenija Gersak ◽  
...  

AbstractTo examine the proportion of iatrogenic births among all preterm births over a 26-year period.A registry-based survey of preterm deliveries between 1987 and 2012 analyzed by the onset of labor: spontaneous with intact membranes, preterm premature rupture of membranes (PPROM) or iatrogenic. Stratification into categories by gestation (22 weeks to 27 weeks and 6 days, 28 weeks to 31 weeks and 6 days, 32 weeks to 33 weeks and 6 days, 34 weeks to 36 weeks and 6 days) was performed. Preterm birth rates were analyzed using the Mantel-Haenszel linear-by-linear associationOverall preterm birth rate was 5.9% (31328 deliveries) including 2358 (0.4%) before 28 completed weeks, 3388 (0.6%) between 28 weeks and 31 weeks 6 days, 3970 (0.8%) between 32 weeks and 33 weeks and 6 days, and 21611 (4.1%) between 34 weeks and 36 weeks and 6 days There was an increase in overall preterm birth rate (P<0.001). The rate of iatrogenic preterm births and PPROM increased over time (P<0.001 and P<0.014, respectively). Rates of spontaneous preterm birth decreased (P<0.001). After accounting for potential confounders, year of birth remained an independent risk factor for iatrogenic preterm delivery in all four gestational age categories (P<0.001).The incidence of iatrogenic preterm birth is increasing with a concomitant decrease in the incidence of spontaneous preterm birth. Attempts to analyze, interpret and decrease preterm birth rates should consider spontaneous and iatrogenic preterm births separately.


2021 ◽  
Vol 6 (8) ◽  
pp. e006359
Author(s):  
Zheng Bian ◽  
Xiaoxian Qu ◽  
Hao Ying ◽  
Xiaohua Liu

ObjectivePreterm birth is the leading cause of child morbidity and mortality globally. We aimed to determine the impact of the COVID-19 mitigation measures implemented in China on 23 January 2020 on the incidence of preterm birth in our institution.DesignLogistic regression analysis was used to investigate the association between the national COVID-19 mitigation measures implemented in China and the incidence of preterm birth.SettingShanghai First Maternity and Infant Hospital, Shanghai China.ParticipantsAll singleton deliveries abstracted from electronic medical record between 1 January 2014 to 31 December 2020.Main outcome measuresPreterm birth rate.ResultsData on 164 107 singleton deliveries were available. COVID-19 mitigation measures were consistently associated with significant reductions in preterm birth in the 2-month, 3-month, 4-month, 5-month time windows after implementation (+2 months, OR 0.80, 95% CI 0.69 to 0.94; +3 months, OR 0.83, 95% CI 0.73 to 0.94; +4 months, OR 0.82, 95% CI 0.73 to 0.92; +5 months, OR 0.84, 95% CI 0.76 to 0.93). These reductions in preterm birth were obvious across various degrees of prematurity, but were statistically significant only in moderate-to-late preterm birth (32 complete weeks to 36 weeks and 6 days) subgroup. The preterm birth difference disappeared gradually after various restrictions were removed (7th–12th month of 2020, OR 1.02, 95% CI 0.94 to 1.11). There was no difference in stillbirth rate across the study time window.ConclusionSubstantial decreases in preterm birth rates were observed following implementation of the national COVID-19 mitigation measures in China. Further study is warranted to explore the underlying mechanisms associated with this observation.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039303
Author(s):  
Shiwen Jing ◽  
Chang Chen ◽  
Yuexin Gan ◽  
Joshua Vogel ◽  
Jun Zhang

ObjectivesTo update the WHO estimate of preterm birth rate in China in 1990–2016 and to further explore variations by geographic regions and years of occurrence.DesignSystematic review and meta-analysis.Data sourcesPubmed, Embase, Cochrane Library and Sinomed databases were searched from 1990 to 2018.Eligibility criteriaStudies were included if they provided preterm birth data with at least 500 total births. Reviews, case–control studies, intervention studies and studies with insufficient information or published before 1990 were excluded. We estimated pooled incidence of preterm birth by a random effects model, and preterm birth rate in different year, region and by livebirths or all births in subgroup analyses.ResultsOur search identified 3945 records. After the removal of duplicates and screening of titles and abstracts, we reviewed 254 studies in full text and excluded 182, leaving 72 new studies. They were combined with the 82 studies included in the WHO report (154 studies, 187 data sets in total for the meta-analysis), including 24 039 084 births from 1990 to 2016. The pooled incidence of preterm birth in China was 6.09% (95% CI 5.86% to 6.31%) but has been steadily increasing from 5.36% (95% CI 4.89% to 5.84%) in 1990–1994 to 7.04% (95% CI 6.09% to 7.99%) in 2015–2016. The annual rate of increase was about 1.05% (95% CI 0.85% to 1.21%). Northwest China appeared to have the highest preterm birth rate (7.3%, 95% CI 4.92% to 9.68% from 1990 to 2016).ConclusionsThe incidence of preterm birth in China has been rising gradually in the past three decades. It was 7% in 2016. Preterm birth rate varied by region with the West having the highest occurrence.


2018 ◽  
Vol 33 (2) ◽  
pp. 215-219 ◽  
Author(s):  
Junichi Sugawara ◽  
Noriyuki Iwama ◽  
Tetsuro Hoshiai ◽  
Hideki Tokunaga ◽  
Hidekazu Nishigori ◽  
...  

AbstractObjectivesThis study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan.MethodsPrimary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis.ResultsFrom overall baseline birth outcomes, a preterm birth rate was 4.6% and low-birth-weight rate was 8.8%. Regional analysis revealed that a preterm birth rate was 3.2% (coastal) and 5.0% (inland), respectively, and the rate of low birth weight was 6.5% in the coastal and 8.5% in the inland region. In the risk analysis of low-birth-weight rate and preterm birth rate, the risk in the coastal region could not be considered any higher than in the inland region (adjusted odds ratio 0.91 [0.73-1.14] and 0.85 [0.46-1.59], respectively).ConclusionsThe incidence of preterm birth and low birth weight were not adversely affected by the disaster. Early transfer and intensive medical intervention may have led to those findings. Further survey will be necessary to determine the long-term effects in both mothers and children.SugawaraJ, IwamaN, HoshiaiT, TokunagaH, NishigoriH, MetokiH, OkamuraK, YaegashiN. Regional birth outcomes after the 2011 Great East Japan Earthquake and tsunami in Miyagi Prefecture. Prehosp Disaster Med. 2018;33(2):215–219.


2018 ◽  
Vol 22 (1) ◽  
pp. 12
Author(s):  
Summer Hunt ◽  
Jennifer P. Hellwig

Author(s):  
Futa Ito ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Tadashi Kimura

Placenta accreta spectrum (PAS) presents one of the highest risks to pregnancy and often requires a cesarean hysterectomy for management, but the challenges associated with this surgery often cause severe obstetric haemorrhaging and high rates of maternal morbidity. Shirodkar cerclage is usually performed in cases with cervical insufficiency, a short cervix with previous preterm birth, etc., to decrease the preterm birth rate. It is recommended that Shirodkar cerclage is removed when the patient approaches term, but the ideal timing of removal for patient for whom cesarean hysterectomy is planned is not clear. Here, authors present a case of PAS in whom Shirodkar cerclage that was difficult to remove at the timing of cesarean hysterectomy. After cesarean hysterectomy, the patient had a vaginal abscess and required antibiotic therapy for approximately two weeks. In the light of our case, authors discuss the timing of removal of cerclage in the cases of PAS.


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