scholarly journals Validity of pre and post-term birth rates based on the date of last menstrual period compared to early obstetric ultrasonography

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.

2021 ◽  
Author(s):  
Yuri Hiramatsu ◽  
Kentaro Isoda ◽  
Takuya Kotani ◽  
Eri Nakamura ◽  
Yumiko Wada ◽  
...  

Abstract Background. This study aimed to clarify predictors of preterm birth in pregnancy of women with systemic lupus erythematosus (SLE). We investigated the predictors of preterm birth before pregnancy from the perspective of the importance of preconception care.Methods. We analysed foetal outcomes of 108 pregnancies in 74 SLE patients. We compared pre-pregnancy clinical characteristics and disease activity in these women between the preterm birth and full-term birth groups to select predictive factors for preterm birth before pregnancy.Results. Eighty-three of 108 pregnancies resulted in live births, of which 27 (25.0%) were preterm births. Pre-pregnancy serum complement 3 (C3) level was significantly lower in the preterm birth group (77.0 mg/dl) than the full-term birth group (87.5 mg/dl) (P = 0.029). Multivariate analysis identified history of lupus nephritis (odds ratio: 5.734, 95% CI: 1.568-21.010, P = 0.008) and low C3 level (<85 mg/dl) at pre-pregnancy (odds ratio: 4.498, 95% CI: 1.296-15.616, P = 0.018) as risk factors for preterm birth. The greater the number of these risk factors, the higher was the preterm birth rate (P = 0.0007). In the case of SLEDAI score ≤ 4, the preterm birth rate was higher in the pre-pregnancy low C3 group (<85 mg / dl) (42.1%) than in the high C3 group (C3 ≥ 85 mg / dl) (14.7%) (P = 0.018).Conclusion. Preconception care improves the outcome of SLE pregnancy. Especially for patients with a history of LN, treatment management focusing on pre-pregnancy serum complement titers is very important.


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 23 (1) ◽  
Author(s):  
Yuri Hiramatsu ◽  
Kentaro Isoda ◽  
Takuya Kotani ◽  
Eri Nakamura ◽  
Yumiko Wada ◽  
...  

Abstract Background This study aimed to clarify predictors of preterm birth in pregnancy of women with systemic lupus erythematosus (SLE). We investigated the predictors of preterm birth before pregnancy from the perspective of the importance of preconception care. Methods We analysed fetal outcomes of 108 pregnancies in 74 SLE patients in a retrospective study. We compared pre-pregnancy clinical characteristics and disease activity in these women between the preterm birth and full-term birth groups to select predictive factors for preterm birth before pregnancy. Results Eighty-three of 108 pregnancies resulted in live births, of which 27 (25.0%) were preterm births. Pre-pregnancy serum complement 3 (C3) level was significantly lower in the preterm birth group (77.0 mg/dl) than the full-term birth group (87.5 mg/dl) (P = 0.029). Multivariate analysis identified history of lupus nephritis (odds ratio: 5.734, 95% CI 1.568–21.010, P = 0.008) and low C3 level (< 85 mg/dl) at pre-pregnancy (odds ratio 4.498, 95% CI 1.296–15.616, P = 0.018) as risk factors for preterm birth. The greater the number of these risk factors, the higher was the preterm birth rate (P = 0.0007). In the case of SLEDAI score ≤ 4, the preterm birth rate was higher in the pre-pregnancy low C3 group (< 85 mg/dl) (42.1%) than in the high C3 group (C3 ≥ 85 mg/dl) (14.7%) (P = 0.018). Conclusion For patients with a history of LN, treatment management focusing on pre-pregnancy serum complement levels is very important.


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.


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