scholarly journals Longitudinal adrenal gland measurements and growth trajectories as risk markers for late preterm delivery

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Janina Goletzke ◽  
Mirja Pagenkemper ◽  
Christian Wiessner ◽  
Franziska Rüber ◽  
Petra Arck ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Propensity Score ◽  
Adrenal Gland ◽  
Clinical Signs ◽  
Low Risk ◽  
Longitudinal Growth ◽  
Propensity Score Method ◽  
Spontaneous Preterm Birth ◽  
Zone Width ◽  
Risk Pregnancy

Abstract Background The fetal adrenal gland receives rising awareness as a predictor of spontaneous preterm birth. We hereby provide longitudinal growth assessments of the fetal adrenal gland in a low risk population with an additional focus on trajectories in fetuses born preterm. Methods Fetal adrenal gland was assessed via transabdominal ultrasound at gestational weeks (gw) 24–26, 28–30, and 34–36 in a low-risk pregnancy cohort. Longitudinal trajectories of the total gland and the mark (so called fetal zone) as well as ratio of fetal zone width/ total widths (w/W) were analyzed using repeated ANOVA analyses. To compare trajectories of the ratio w/W for preterm and term fetuses respectively, as well as women with and without clinical signs of preterm labor, the propensity score method was applied. Results Fetal zone width increased over the course of pregnancy (p < 0.0001), while the ratio w/W decreased (p < 0.0001) (n = 327). Comparing the trajectories of the ratio w/W in fetuses born preterm (n = 11) with propensity-score matched term born fetuses (n = 22), a decrease between gw 24–26 and 28–30 was observed in both groups, which continued to decrease for the term born fetuses. However, in preterm born fetuses, the ratio increased above the term born values at gw 34–36. Conclusion Our study provides for the first time longitudinal growth data on the fetal adrenal gland and supports the hypothesis that fetal zone enlargement is associated with preterm birth which could play an important role in risk-prediction.

The Preterm Prediction Study: Can low-risk women destined for spontaneous preterm birth be identified?

2001 ◽  
Vol 184 (4) ◽  
pp. 652-655 ◽  
Author(s):  
J.D. Iams ◽  
R.L. Goldenberg ◽  
B.M. Mercer ◽  
A.H. Moawad ◽  
P.J. Meis ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Low Risk ◽  
Spontaneous Preterm Birth ◽  
Low Risk Women

scholarly journals 424: Uterocervical angle does not predict spontaneous preterm birth in either a low-risk or high-risk group: A prospective study

2018 ◽  
Vol 218 (1) ◽  
pp. S258
Author(s):  
Courtney Olson-Chen ◽  
Kam Szlachetka ◽  
Dzhamala Gilmandyar ◽  
Erica Faske ◽  
Elizabeth Fountaine ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Prospective Study ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Spontaneous Preterm Birth ◽  
Group A ◽  
A Prospective Study

Effectiveness of 17-OHP for Prevention of Recurrent Preterm Birth: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Blair J. Wylie ◽  
Andrew L. Beam ◽  
Joe B. Hakim ◽  
Amy Zhou ◽  
Sonia Hernandez-Diaz ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Propensity Score ◽  
Evidence Base ◽  
Inclusion Criteria ◽  
Spontaneous Preterm Birth ◽  
Real World Data ◽  
Recurrence Rates ◽  
Key Points ◽  
Hydroxyprogesterone Caproate ◽  
Risk Ratios

Objective 17-α-hydroxyprogesterone caproate (17-OHP) has been recommended by professional societies for the prevention of recurrent preterm birth, but subsequent clinical studies have reported conflicting efficacy results. This study aimed to contribute to the evidence base regarding the effectiveness of 17-OHP in clinical practice using real-world data. Study Design A total of 4,422 individuals meeting inclusion criteria representing recurrent spontaneous preterm birth (sPTB) were identified in a database of insurance claims, and 568 (12.8%) received 17-OHP. Crude and propensity score-matched recurrence rates and risk ratios (RRs) for the association of receiving 17-OHP on recurrent sPTB were calculated. Results Raw sPTB recurrence rates were higher among those treated versus not treated; after propensity score matching, no association was detected (26.3 vs. 23.8%, RR = 1.1, 95% CI: 0.9–1.4). Conclusion We failed to identify a beneficial effect of 17-OHP for the prevention of spontaneous recurrent preterm birth in our observational, U.S. based cohort. Key Points

Delivery prediction in pregnant women with spontaneous preterm birth using fetal adrenal gland biometry

2016 ◽  
Vol 29 (23) ◽  
pp. 3756-3761 ◽  
Author(s):  
Aline Pinto Lemos ◽  
Francisco Edson de Lucena Feitosa ◽  
Edward Araujo Júnior ◽  
Helvécio Neves Feitosa ◽  
João Gabriel Damasceno Pereira ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Adrenal Gland ◽  
Pregnant Women ◽  
Spontaneous Preterm Birth

scholarly journals Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study

Ultrasound ◽  
2018 ◽  
Vol 26 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Shubhra Agarwal ◽  
Arjit Agarwal ◽  
Pawan Joon ◽  
Shalini Saraswat ◽  
Shruti Chandak
Keyword(s):  
Preterm Birth ◽  
Adrenal Gland ◽  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Wave Speed ◽  
Clinical Signs ◽  
Developed Countries ◽  
Speed Estimation ◽  
Major Health Problem ◽  
Shear Wave Speed

Background Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities. Methods Thirty pregnant females (from 28 to 37 weeks of gestational age), showing clinical signs and delivery outcome of preterm birth were included in the study with an equal number of not-in-labor antenatal females at ≥37 weeks as controls. These patients were categorized as preterm and term groups. Both the groups were subjected to trans-abdominal ultrasonography where cervical length, cervical shear wave speed (dynamic elastography) and fetal adrenal gland parameters were measured. Results Shear wave speed estimation of the antenatal cervix showed the highest sensitivity and specificity (96.7% and 87% respectively) in the prediction of preterm birth and also showed a strong correlation with fetal adrenal gland enlargement. Fetal adrenal zone enlargement was also shown to be a reliable marker of preterm birth, however, with reduced sensitivity and specificity than shear wave speed. Conclusion The elastographic advancement and fetal adrenal biometry derived quantitative markers can be used as an objective and standard criterion for accurate prediction of preterm birth.

scholarly journals Impact of history of myomectomy on preterm birth risk in women with a leiomyomatous uterus: a propensity score analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emmanuel Rault ◽  
Pierre Delorme ◽  
François Goffinet ◽  
Aude Girault
Keyword(s):  
Preterm Birth ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Spontaneous Preterm Birth ◽  
Multivariable Logistic Regression Model ◽  
Score Analysis ◽  
Tertiary Center ◽  
History Of

Abstract Background To evaluate if women with a history of myomectomy have a modified preterm birth risk compared to women with myomas during pregnancy. Methods Retrospective cohort study including all women with a history of myomectomy (operated group) or uterine myomas during pregnancy (unoperated group) who delivered in a tertiary center between January, 2011 and December, 2017. The operated group included women who had a myomectomy history with or without myomas during the ongoing pregnancy. The unoperated group included women with uterine myoma(s) seen on at least one ultrasound during pregnancy without history of myomectomy. The primary outcome was preterm birth < 37 weeks, and the secondary outcome spontaneous preterm birth < 37 weeks. To control for confounding factors, a propensity score approach was used. Two sensitivity analysis were performed, one repeating the analysis using the propensity score after excluding operated women with persistent myomas and one using a classical multivariable logistic regression model. Results The cohort included 576 women: 283 operated women and 293 unoperated women. The rate of preterm birth was similar in the two groups: 12.6% in the unoperated group and 12.0% in the operated group (p = 0.82). No difference in preterm birth risk was shown between unoperated and operated women in the cohort matched on the propensity score: OR 0.86; 95%CI [0.47–1.59]. These results were consistent for spontaneous preterm birth (OR 1.61; 95%CI [0.61–4.23]) and for the sensitivity analyses. Conclusion In women with a leiomyomatous uterus, a history of myomectomy is not associated with a reduced preterm birth risk.

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