Faculty Opinions recommendation of Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.

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.

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Predictive performance of PAMG-1 vs fFN test for risk of spontaneous preterm birth in symptomatic women attending an emergency obstetric unit: retrospective cohort study

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.18892 ◽

2018 ◽

Vol 51 (5) ◽

pp. 644-649 ◽

Cited By ~ 13

Author(s):

J. C. Melchor ◽

H. Navas ◽

M. Marcos ◽

A. Iza ◽

M. De Diego ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Predictive Performance ◽

Spontaneous Preterm Birth

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Impact of preconception vaginal microbiota on women’s risk of spontaneous preterm birth: protocol for a prospective case-cohort study

BMJ Open ◽

10.1136/bmjopen-2019-035186 ◽

2020 ◽

Vol 10 (2) ◽

pp. e035186 ◽

Cited By ~ 2

Author(s):

Erica M Lokken ◽

Kishorchandra Mandaliya ◽

Sujatha Srinivasan ◽

Barbra A Richardson ◽

John Kinuthia ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Umbilical Cord ◽

Bacterial Species ◽

Vaginal Microbiota ◽

Fetal Membrane ◽

Fetal Membranes ◽

Rrna Gene ◽

Spontaneous Preterm Birth ◽

Increased Risk

IntroductionBacterial vaginosis (BV) and vaginal microbiota disruption during pregnancy are associated with increased risk of spontaneous preterm birth (SPTB), but clinical trials of BV treatment during pregnancy have shown little or no benefit. An alternative hypothesis is that vaginal bacteria present around conception may lead to SPTB by compromising the protective effects of cervical mucus, colonising the endometrial surface before fetal membrane development, and causing low-level inflammation in the decidua, placenta and fetal membranes. This protocol describes a prospective case-cohort study addressing this hypothesis.Methods and analysisHIV-seronegative Kenyan women with fertility intent are followed from preconception through pregnancy, delivery and early postpartum. Participants provide monthly vaginal specimens during the preconception period for vaginal microbiota assessment. Estimated date of delivery is determined by last menstrual period and first trimester obstetrical ultrasound. After delivery, a swab is collected from between the fetal membranes. Placenta and umbilical cord samples are collected for histopathology. Broad-range 16S rRNA gene PCR and deep sequencing of preconception vaginal specimens will assess species richness and diversity in women with SPTB versus term delivery. Concentrations of key bacterial species will be compared using quantitative PCR (qPCR). Taxon-directed qPCR will also be used to quantify bacteria from fetal membrane samples and evaluate the association between bacterial concentrations and histopathological evidence of inflammation in the fetal membranes, placenta and umbilical cord.Ethics and disseminationThis study was approved by ethics committees at Kenyatta National Hospital and the University of Washington. Results will be disseminated to clinicians at study sites and partner institutions, presented at conferences and published in peer-reviewed journals. The findings of this study could shift the paradigm for thinking about the mechanisms linking vaginal microbiota and prematurity by focusing attention on the preconception vaginal microbiota as a mediator of SPTB.

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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 ◽

Prospective Cohort Study ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Spontaneous Preterm Birth ◽

Stop Smoking ◽

In Pregnancy

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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 ◽

Prospective Cohort Study ◽

Fetal Growth ◽

Early Pregnancy ◽

Prospective Cohort ◽

Preterm Births ◽

Second Trimester ◽

Spontaneous Preterm Birth ◽

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.

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Nomogram to Early Screen Multiparous Women for Preterm Birth in a Cohort Study

International Journal of Biology and Biomedical Engineering ◽

10.46300/91011.2021.15.17 ◽

2021 ◽

Vol 15 ◽

pp. 135-141

Author(s):

Mayssa A. Traboulsi ◽

Zainab. El Alaoui Talibi ◽

Abdellatif Boussaid

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Low Income ◽

Health Indicators ◽

Penalized Regression ◽

Low Income Countries ◽

Medical Surveillance ◽

Spontaneous Preterm Birth ◽

Multiparous Women ◽

Low Prevalence

Preterm Birth (PTB) can negatively affect the health of mothers as well as infants. Prediction of this gynecological complication remains difficult especially in Middle and Low-Income countries because of limited access to specific tests and data collection scarcity. Machine learning methods have been used to predict PTB but the low prevalence of this pregnancy complication led to rather low prediction values. The objective of this study was to produce a nomogram based on improved prediction for low prevalence PTB using up sampling and lasso penalized regression. We used data from a cohort study in Northern Lebanon of 922 multiparous presenting a PTB prevalence of 8%. We analyzed the personal, demographic, and health indicators available for this group of women. The improved Positive Predictive Value for PTB reached around 88%. The regression coefficients of the 6 selected variables (Pre-hemorrhage, Social status, Residence, Age, BMI, and Weight gain) were used to create a nomogram to screen multiparous women for PTB risk. The nomogram based on readily available indicators for multiparous women reasonably predicted most of the at PTB risk women. The physicians can use this tool to screen for women at high risk for spontaneous preterm birth to improve medical surveillance that can reduce PTB incidence.

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