Impact of antenatal lifestyle education on reducing preterm birth: A retrospective cohort study

Objective Investigate the effect of an antenatal lifestyle education seminar on reducing preterm birth, and whether education timing modifies outcomes among women with different characteristics. Design Retrospective cohort study Setting A metropolitan hospital in Beijing, China Population A total of 3008 singleton livebirths Methods Extracted data from deidentified electronic medical records were analyzed. Odds ratios (ORs) for preterm birth according to antenatal education attendance using stepwise binary logistic regression stratified by different maternal characteristics was conducted. Outcome measure Preterm birth (gestational age <37+0 weeks) Results Overall prevalence of preterm birth was 8.7%, but higher for women who did not attend the antenatal seminar (11.5%). Risk of preterm birth for first trimester attendees decreased by 53% ([OR] 0.47, 95% CI 0.35-0.64), and 41% for later attendees ([OR] 0.59, 95% CI 0.41-0.86). Estimates persisted after adjusting pre-existing and gestational covariates. In subgroup analysis, young or nulliparous women who attended later than first trimester were at decreased risk. For women aged ≥35 years, multiparous, who had a previous caesarean section/myomectomy, the risk of preterm birth was reduced among first trimester attendees, but no longer significant after adjusting for pre-existing and gestational covariates (p > 0.05). Timing of the seminar was not significant for women received assisted reproductive technologies. Conclusions Offering an antenatal lifestyle education seminar was associated with lower preterm birth risk and was modified by education timing and women’s characteristics. Results can inform the development of tailored preterm birth prevention strategies. Keywords Antenatal education, lifestyle factors, preterm birth, intervention timing, health promotion.

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Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm9041108 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1108 ◽

Cited By ~ 1

Author(s):

Jessica M. Turner ◽

Sailesh Kumar

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Protein A ◽

First Trimester ◽

Neonatal Outcomes ◽

Increased Risk ◽

Adverse Neonatal Outcomes ◽

Fetal Compromise

The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother’s Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 +0 and 13 +6 weeks gestation during the study period were included. Data were extracted from the institution’s perinatal database and dichotomized according to PAPP-A level (≤0.4 Multiples of Medium (MoM) vs. >0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A ≤ 0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24–2.46, p = 0.66) or SCNO (aOR 0.65, 95% CI 0.39–1.07, p = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight < 10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth.

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The Association between Periconceptional Folic Acid Supplementation with the Risk of Preterm Birth: A Population-Based Retrospective Cohort Study of 200,000 Women in China

SSRN Electronic Journal ◽

10.2139/ssrn.3559621 ◽

2020 ◽

Author(s):

Yu Wu ◽

Yanling Yuan ◽

Cai Kong ◽

Qiuyue Ma ◽

Hanfeng Ye ◽

...

Keyword(s):

Cohort Study ◽

Folic Acid ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Folic Acid Supplementation ◽

Acid Supplementation

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

Neonatology ◽

10.1159/000515089 ◽

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

Introduction: Late preterm infants (LPIs) are infants born between 340/7 and 366/7 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. Methods: 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. Results: 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 360−6 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. Discussion and Conclusion: 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.

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Relationship between vaginal group B streptococcus colonization in the early stage of pregnancy and preterm birth: a retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sho Tano ◽

Takuji Ueno ◽

Michinori Mayama ◽

Takuma Yamada ◽

Takehiko Takeda ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Early Stage ◽

Group B Streptococcus ◽

Multivariable Logistic Regression Analysis ◽

Simple Method ◽

Group B ◽

Singleton Pregnancies

Abstract Background Although infection and inflammation within the genital tract during pregnancy is considered a major risk factor for spontaneous preterm birth (PTB), there are few studies on association between vaginal microorganisms in the early stage of pregnancy and PTB. The aim of this study was to investigate relationship between vaginal Group B streptococcus (GBS) colonization, a leading cause of infection during pregnancy, in the early stage of pregnancy and PTB. Methods This single-center, retrospective cohort study utilized data from 2009 to 2017 obtained at TOYOTA Memorial Hospital. Women with singleton pregnancies who underwent vaginal culture around 14 weeks of gestation during their routine prenatal check-up were included. Vaginal sampling for Gram staining and culture was performed regardless of symptoms. GBS colonization was defined as positive for GBS latex agglutination assay. Statistical analysis was performed to determine the factors associated with PTB. Results Overall 1079 singleton pregnancies were included. GBS (5.7%) and Candida albicans (5.5%) were the most frequently observed microorganisms. The incidence of PTB (before 34 and before 37 weeks of gestation) were significantly higher in the GBS-positive group than in the GBS-negative group (6.6% vs 0.5%, p = 0.001 and 9.8% vs 4.3%, p = 0.047). Our multivariable logistic regression analysis revealed that GBS colonization was a factor associated with PTB before 34 and before 37 weeks of gestation (Odds ratio [OR] 15.17; 95% confidence interval [CI] 3.73–61.74), and OR 2.42; 95%CI 1.01–5.91, respectively). Conclusions The present study found that vaginal GBS colonization in the early stage of pregnancy was associated with PTB. Our study indicates that patients at a high risk for PTB can be extracted by a simple method using conventional culture method.

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Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03467-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Zeng ◽

Erica Erwin ◽

Wendy Wen ◽

Daniel J. Corsi ◽

Shi Wu Wen ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Preterm Birth ◽

Cesarean Section ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Population Based ◽

Adverse Perinatal Outcomes

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

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