scholarly journals Association Between Features of Spontaneous Late Preterm Labor and Late Preterm Birth

2019 ◽  
Vol 37 (04) ◽  
pp. 357-364
Author(s):  
Angelica V. Glover ◽  
Ashley N. Battarbee ◽  
Cynthia Gyamfi-Bannerman ◽  
Kim A. Boggess ◽  
Grecio Sandoval ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Secondary Analysis ◽  
Area Under The Curve ◽  
Late Preterm ◽  
P Value ◽  
Cervical Dilation ◽  
Late Preterm Birth ◽  
Gestational Age At Delivery

Abstract Objective This study aimed to evaluate the association between clinical and examination features at admission and late preterm birth. Study Design The present study is a secondary analysis of a randomized trial of singleton pregnancies at 340/7 to 365/7 weeks' gestation. We included women in spontaneous preterm labor with intact membranes and compared them by gestational age at delivery (preterm vs. term). We calculated a statistical cut-point optimizing the sensitivity and specificity of initial cervical dilation and effacement at predicting preterm birth and used multivariable regression to identify factors associated with late preterm delivery. Results A total of 431 out of 732 (59%) women delivered preterm. Cervical dilation ≥ 4 cm was 60% sensitive and 68% specific for late preterm birth. Cervical effacement ≥ 75% was 59% sensitive and 65% specific for late preterm birth. Earlier gestational age at randomization, nulliparity, and fetal malpresentation were associated with late preterm birth. The final regression model including clinical and examination features significantly improved late preterm birth prediction (81% sensitivity, 48% specificity, area under the curve = 0.72, 95% confidence interval [CI]: 0.68–0.75, and p-value < 0.01). Conclusion Four in 10 women in late-preterm labor subsequently delivered at term. Combination of examination and clinical features (including parity and gestational age) improved late-preterm birth prediction.

scholarly journals Morbidity in Late Preterm Birth: A Retrospective Cohort Study Assessing the Role of Immaturity versus Antecedent Factors

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Melissa Lorenzo ◽  
Megan Laupacis ◽  
Wilma M. Hopman ◽  
Imtiaz Ahmad ◽  
Faiza Khurshid
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Late Preterm ◽  
Multiple Gestation ◽  
Late Preterm Birth ◽  
Apnea Of Prematurity

<b><i>Introduction:</i></b> Late preterm infants (LPIs) are infants born between 34<sup>0/7</sup> and 36<sup>6/7</sup> weeks gestation. Morbidities in these infants are commonly considered a result of prematurity; however, some research has suggested immaturity may not be the sole cause of morbidities. We hypothesize that antecedents leading to late preterm birth are associated with different patterns of morbidities and that morbidities are the result of gestational age superimposed by the underlying etiologies of preterm delivery. <b><i>Methods:</i></b> This is a retrospective cohort study of late preterm neonates born at a single tertiary care center. We examined neonatal morbidities including apnea of prematurity, hyperbilirubinemia, hypoglycemia, and the requirement for continuous positive airway pressure (CPAP). Multivariable logistic regression analysis was performed to estimate the risk of each morbidity associated with 3 categorized antecedents of delivery, that is, spontaneous preterm labor, preterm premature rupture of membranes (PPROM), and medically indicated birth. We calculated the predictive probability of each antecedent resulting in individual morbidity across gestational ages. <b><i>Results:</i></b> 279 LPIs were included in the study. Decreasing gestational age was associated with significantly increased risk of apnea of prematurity, hyperbilirubinemia, and requirement of CPAP. In our cohort, the risk of hypoglycemia increased with gestational age, with the greatest incidence at 36<sup>0−6</sup> weeks. There was no significant association of risk of selected morbidities and the antecedents of late preterm delivery, with or without adjustment for gestational age, multiple gestation, small for gestational age (SGA), antenatal steroids, and delivery method. <b><i>Discussion and Conclusion:</i></b> This study found no difference in morbidity risk related to 3 common antecedents of preterm birth in LPIs. Our research suggests that immaturity is the primary factor in determining adverse outcomes, intensified by factors resulting in prematurity.

scholarly journals 671: True vs. false spontaneous preterm labor in the late preterm period: Predicting late preterm birth

2018 ◽  
Vol 218 (1) ◽  
pp. S403
Author(s):  
Angelica V. Glover ◽  
Ashley N. Battarbee ◽  
Cynthia Gyamfi-Bannerman ◽  
Kim A. Boggess ◽  
Tracy A. Manuck
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Late Preterm ◽  
Late Preterm Birth

Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Joohee Choi ◽  
Jeong Woo Park ◽  
Byoung Jae Kim ◽  
Ye-Jin Choi ◽  
Jong Hee Hwang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Cervical Insufficiency ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Histologic Chorioamnionitis ◽  
Gestational Age At Delivery ◽  
The Difference

AbstractTo compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.: The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.

Changes in the Gestational Age Distribution among U.S. Singleton Births: Impact on Rates of Late Preterm Birth, 1992 to 2002

2006 ◽  
Vol 30 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Michael J. Davidoff ◽  
Todd Dias ◽  
Karla Damus ◽  
Rebecca Russell ◽  
Vani R. Bettegowda ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Age Distribution ◽  
Late Preterm ◽  
Late Preterm Birth

scholarly journals Impact of gestational age on child intelligence, attention and executive function at age 5: a cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028982 ◽  
Author(s):  
Emilie Pi Fogtmann Sejer ◽  
Frederik Jager Bruun ◽  
Julie Anna Slavensky ◽  
Erik Lykke Mortensen ◽  
Ulrik Schiøler Kesmodel
Keyword(s):  
Cohort Study ◽  
Executive Function ◽  
Preterm Birth ◽  
Gestational Age ◽  
Parental Education ◽  
Mean Difference ◽  
Late Preterm ◽  
Late Preterm Birth ◽  
The Mean ◽  
The Impact

ObjectivesPreterm birth can affect cognition, but other factors including parental education and intelligence may also play a role, but few studies have adjusted for these potential confounders. We aimed to assess the impact of gestational age (GA), late preterm birth (34 to <37 weeks GA) and very to moderately preterm birth (<34 weeks GA) on intelligence, attention and executive function in a population of Danish children aged 5 years.DesignPopulation-based prospective cohort study.SettingDenmark 2003–2008.ParticipantsA cohort of 1776 children and their mothers sampled from the Danish National Birth Cohort with information on GA, family and background factors and completed neuropsychological assessment at age 5.Primary outcome measuresWechsler Preschool and Primary Scale of Intelligence-Revised, Test of Everyday Attention for Children at Five and Behaviour Rating Inventory of Executive Function scores.ResultsFor preterm birth <34 weeks GA (n=8), the mean difference in full-scale intelligence quotient(IQ) was −10.6 points (95% CI −19.4 to −1.8) when compared with the term group ≥37 weeks GA (n=1728), and adjusted for potential confounders. For the teacher-assessed Global Executive Composite, the mean difference was 5.3 points (95% CI 2.4 to 8.3) in the adjusted analysis, indicating more executive function difficulties in the preterm group <34 weeks GA compared with the term group. Maternal intelligence and parental education were weak confounders. No associations between late preterm birth 34 to <37 weeks GA (n=40) and poor cognition were shown.ConclusionsThis study showed substantially lower intelligence and poorer executive function in children born <34 weeks GA compared with children born at term. GA may play an important role in determining cognitive abilities independent of maternal intelligence and parental education. Studies with larger sample sizes are needed to confirm these findings, as the proportion of children born preterm in this study population was small.

scholarly journals Vaginal progesterone supplementation in the management of preterm labor: A randomized controlled trial

2020 ◽  
Author(s):  
Ratanawadee Sirisangwon ◽  
Vorapong Phupong
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Latency Period ◽  
Antenatal Corticosteroids ◽  
Randomized Controlled ◽  
Vaginal Progesterone ◽  
Gestational Age At Delivery

Abstract BackgroundPreterm labor is a common obstetric complication and can lead to preterm delivery. Preterm birth or preterm delivery is the leading cause of neonatal morbidity and mortality, especially when preterm birth occurs at a gestational age less than 34 weeks. The primary objective in this study was to evaluate the effects of vaginal progesterone supplementation for the prolongation of the latency period in preterm labor. The secondary objectives were to evaluate gestational age at delivery, rates of preterm birth less than 34 and 37 weeks, obstetric outcomes, maternal compliance with medication use, and side effects.MethodsA randomized controlled trial was performed. Ninety women with preterm labor occurring at 24 to 34 weeks were either randomized to a vaginal progesterone group (44 women) receiving tocolytic and antenatal corticosteroids treatment combined with vaginal micronized progesterone (400 mg everyday) or to the no-progesterone group (46 women) receiving tocolytic and antenatal corticosteroids treatment only.ResultsLatency periods were more prolonged in the vaginal progesterone group than in the no-progesterone group (32.8 ± 18.7 vs. 25.8 ± 22.7 days, p = 0.045). Gestational age at delivery in the vaginal progesterone group was also higher than in the no-progesterone group (36.5 ± 2.9 vs. 34.9 ± 3.7 weeks, p = 0.022). There were significant reduction rates of preterm birth less than 34 weeks (13.6% vs. 39.1%, p = 0.012), low birth weight (29.5% vs. 50%, p = 0.048), neonatal respiratory distress syndrome (13.6% vs. 37%, p=0.021), and neonatal intensive care unit admission (6.8% vs. 28.3%, p = 0.017).ConclusionCombined treatment with vaginal progesterone 400 mg could prolong the latency period in preterm labor when compared with no progesterone. Further, this approach could decrease the rates of preterm birth less than 34 weeks, low birth weight, and neonatal respiratory distress syndrome.

scholarly journals Clinical Implications of SARS-CoV-2 Infection in the Viable Preterm Period

2020 ◽  
Vol 37 (11) ◽  
pp. 1077-1083 ◽  
Author(s):  
Moti Gulersen ◽  
Matthew J. Blitz ◽  
Burton Rochelson ◽  
Michael Nimaroff ◽  
Weiwei Shan ◽  
...  
Keyword(s):  
Gestational Age ◽  
Preterm Labor ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Late Preterm ◽  
Age At Diagnosis ◽  
P Value ◽  
Cross Sectional ◽  
Key Points ◽  
Diagnosis Of Infection

Objective This study aimed to determine the rate of preterm birth (PTB) during hospitalization among women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between 23 and 37 weeks of gestation and whether this rate differs by gestational age at diagnosis of infection. Study Design Retrospective, cross-sectional study of all women diagnosed with SARS-CoV-2 infection between 23 and 37 weeks of gestation within a large integrated health system from March 13 to April 24, 2020. Cases with severe fetal structural malformations detected prior to infection were excluded. Women were stratified into two groups based on gestational age at diagnosis: early preterm (230/7 to 336/7 weeks) versus late preterm (34 to 366/7 weeks). We compared the rate of PTB during hospitalization with infection between the two groups. Statistical analysis included use of Wilcoxon rank sum and Fisher exact tests, as well as a multivariable logistic regression. Statistical significance was defined as a p-value <0.05. Results Of the 65 patients included, 36 (53.7%) were diagnosed in the early preterm period and 29 (46.3%) were diagnosed in the late preterm period. Baseline demographics were similar between groups. The rate of PTB during hospitalization with infection was significantly lower among women diagnosed in the early preterm period compared with late preterm (7/36 [19.4%] vs. 18/29 [62%], p-value = 0.001). Of the 25 patients who delivered during hospitalization with infection, the majority were indicated deliveries (64%, 16/25). There were no deliveries <33 weeks of gestation for worsening coronavirus disease 2019 and severity of disease did not alter the likelihood of delivery during hospitalization with SARS-CoV-2 infection (adjusted odds ratio [aOR]: 0.64; 95% confidence interval [CI]: 0.24–1.59). Increased maternal age was associated with a lower likelihood of delivery during hospitalization with SARS-CoV-2 infection (aOR: 0.77; 95% CI: 0.58–0.96), while later gestational age at diagnosis of infection was associated with a higher likelihood of delivery during hospitalization (aOR: 2.9; 95% CI: 1.67–8.09). Conclusion The likelihood of PTB during hospitalization with SARS-CoV-2 infection is significantly lower among women diagnosed in the early preterm period compared with late preterm. Most women with SARS-CoV-2 infection in the early preterm period recovered and were discharged home. The majority of PTB were indicated and not due to spontaneous preterm labor. Key Points

Comparison of oral Dydrogesterone and 17-α hydroxyprogesterone caprate in the prevention of preterm birth

2021 ◽  
Author(s):  
Fahimeh Alizadeh ◽  
Malihe Mahmoudinia ◽  
Masoumeh Mirteimoori ◽  
Lila Pourali
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Latency Period ◽  
Obstetric Care ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Gestational Age At Delivery

Abstract Background: Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB.Methods :In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30mg oral Dydrogesterone daily, 250mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery.Results: Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06±17.29 vs. 29.44±15.6 and 22.20±4.51 days, respectively; P<0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P<0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes.Conclusion: Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.

Sign in / Sign up

Export Citation Format

Share Document