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

Fetal Growth ◽

Early Pregnancy ◽

Prospective Cohort ◽

Late Gestation ◽

Second Trimester ◽

Increased Risk

Abstract Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth. Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored. Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not earlier births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower risk for both overall and spontaneous preterm birth.Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased risk of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the likelihood for preterm birth.

Spontaneous Preterm Birth and Small for Gestational Age Infants in Women Who Stop Smoking Early in Pregnancy: Prospective Cohort Study

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000370503.15340.65 ◽

2010 ◽

Vol 30 (2) ◽

pp. 91-92

Author(s):

L.M. McCowan ◽

G.A. Dekker ◽

E. Chan ◽

A. Stewart ◽

L.C. Chappell ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Stop Smoking ◽

In Pregnancy

Accelerated fetal growth in early pregnancy and risk of preterm birth: a prospective cohort study

10.21203/rs.3.rs-39242/v5 ◽

2020 ◽

Author(s):

Evangelia Elenis ◽

Anna-Karin Wikström ◽

Marija Simic

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Fetal Growth ◽

Early Pregnancy ◽

Prospective Cohort ◽

Preterm Births ◽

Second Trimester ◽

Very Preterm

Abstract Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth. Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored. Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not very preterm births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower odds for both overall and spontaneous preterm birth.Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased odds of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the risk for preterm birth.

Faculty Opinions recommendation of Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1159931.620187 ◽

2009 ◽

Author(s):

Mark Turner

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Stop Smoking ◽

In Pregnancy

Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/s1090-798x(10)79361-9 ◽

2010 ◽

Vol 2010 ◽

pp. 162-164

Author(s):

J.S. Dungan

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Stop Smoking ◽

In Pregnancy

The Predictive Value of the Cervical Consistency Index to Predict Spontaneous Preterm Birth in Asymptomatic Twin Pregnancies at the Second-Trimester Ultrasound Scan: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm9061784 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1784

Author(s):

Johannes van der Merwe ◽

Isabel Couck ◽

Francesca Russo ◽

Xavier P. Burgos-Artizzu ◽

Jan Deprest ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Prospective Cohort ◽

Transvaginal Ultrasound ◽

Characteristic Curve ◽

Cervical Length ◽

Consistency Index ◽

Twin Pregnancies

Novel transvaginal ultrasound (TVU) markers have been proposed to improve spontaneous preterm birth (sPTB) prediction. Preliminary results of the cervical consistency index (CCI), uterocervical angle (UCA), and cervical texture (CTx) have been promising in singletons. However, in twin pregnancies, the results have been inconsistent. In this prospective cohort study of asymptomatic twin pregnancies assessed between 18+0–22+0 weeks, we evaluated TVU derived cervical length (CL), CCI, UCA, and the CTx to predict sPTB < 34+0 weeks. All iatrogenic PTB were excluded. In the final cohort of 63 pregnancies, the sPTB rate < 34+0 was 16.3%. The CCI, UCA, and CTx, including the CL was significantly different in the sPTB < 34+0 weeks group. The best area under the receiver operating characteristic curve (AUC) for sPTB < 34+0 weeks was achieved by the CCI 0.82 (95%CI, 0.72–0.93), followed by the UCA with AUC 0.72 (95%CI, 0.57–0.87). A logistic regression model incorporating parity, chorionicity, CCI, and UCA resulted in an AUC of 0.91 with a sensitivity of 55.3% and specificity of 88.1% for predicting sPTB < 34+0. The CCI performed better than other TVU markers to predict sPTB < 34+0 in twin gestations, and the best diagnostic accuracy was achieved by a combination of parity, chorionicity, CCI, and UCA.

Modified classification of Gram-stained vaginal smears to predict spontaneous preterm birth: a prospective cohort study

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.12.026 ◽

2007 ◽

Vol 196 (6) ◽

pp. 528.e1-528.e6 ◽

Cited By ~ 21

Author(s):

Hans Verstraelen ◽

Rita Verhelst ◽

Kristien Roelens ◽

Geert Claeys ◽

Steven Weyers ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Prospective Cohort ◽

Vaginal Smears

Marijuana Use during Pregnancy and Preterm Birth: A Prospective Cohort Study

American Journal of Perinatology ◽

10.1055/s-0040-1708802 ◽

2020 ◽

Author(s):

Mark A. Klebanoff ◽

Diana G. Wilkins ◽

Sarah A. Keim

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Relative Risk ◽

High Risk ◽

Prospective Cohort ◽

Marijuana Use ◽

Adjusted Relative Risk ◽

Increased Risk

Objective The aim of this study is to estimate the association between marijuana use during pregnancy and total, spontaneous and indicated preterm birth. Study Design Prospective cohort study of women receiving antenatal care at The Ohio State University from 2010 to 2015. Marijuana use was assessed by questionnaire, record abstraction, and urine toxicology. Women were followed through the end of pregnancy. Relative risks were assessed with Poisson regression and time to delivery with proportional hazard models. Results Of 363 eligible women, 119 (33%) used marijuana in pregnancy by at least one measure. In this high-risk cohort, preterm birth occurred to 36.0% of users and 34.6% of nonusers (p = 0.81). The unadjusted relative risk of all preterm birth was 1.06 (95% confidence interval [CI]: 0.76–1.47); the adjusted relative risk was similar 1.04 (95% CI: 0.72–1.50). Spontaneous preterm birth was nonsignificantly elevated among users before 1.32 (95% CI: 0.89–1.96), and after 1.21 (95% CI: 0.76–1.94) adjustment. Indicated preterm birth was nonsignificantly reduced before 0.52 (95% CI: 0.22–1.23) and after 0.75 (95% CI: 0.29–2.15) adjustment. The unadjusted hazard ratio (HR) for time to preterm birth was 1.26 (95% CI: 0.84–2.00); the adjusted HR was 1.32 (95% CI: 0.80–2.07). Both unadjusted 1.77 (95% CI: 1.06–2.93) and adjusted 2.16 (95% CI: 1.16–4.02) HRs for spontaneous preterm birth were significantly elevated, primarily due to an increased risk of spontaneous birth <28 weeks among users. The unadjusted and adjusted HRs for time to indicated preterm birth were 0.69 (95% CI: 0.33–1.43) and 0.58 (95% CI: 0.23–1.46). Conclusion Marijuana use was not associated with total preterm birth in this cohort, suggesting that among women already at high risk of preterm birth, marijuana does not increase risk further. However, there was a suggestion that pregnant women who use marijuana may deliver earlier, particularly from spontaneous preterm birth, than women who do not use marijuana.

Accelerated fetal growth in early pregnancy and risk of preterm birth: a prospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03458-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Evangelia Elenis ◽

Anna-Karin Wikström ◽

Marija Simic

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Fetal Growth ◽

Early Pregnancy ◽

Prospective Cohort ◽

Preterm Births ◽

Second Trimester ◽

Very Preterm

Abstract Background Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth. Methods This prospective cohort study included 69,617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored. Results The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20–1.54). The findings remained significant what regards moderate preterm births but not very preterm births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11–1.63). On the contrary, fetuses with delayed fetal growth exhibited lower odds for both overall and spontaneous preterm birth. Conclusions Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased odds of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the risk for preterm birth.