scholarly journals EPIDEMIOLOGY AND RISK FACTORS FOR PREMATURE BIRTH

2018 ◽  
Vol 28 (2) ◽  
pp. 629-636
Author(s):  
Anna Mihaylova ◽  
Nikoleta Parahuleva ◽  
Elina Petkova-Gueorguieva ◽  
Stanislav Gueorguiev

Premature birth is a significant medical, social and economic problem worldwide. In the 21st Century in developed countries, this problem accounts for over two thirds of neonatal deaths. In Bulgaria, statistics show that 10-12% of all pregnancies end with premature birth. Despite the number of studies in this field and the efforts made by obstetricians and gynecologists, the tendency to increase the number of preterm births has continued in the last decade. Its consequences are multiple complications who lead to a high neonatal mortality in the national and global world. Preterm birth is characterized by complex and vague etiology. A specific cause of premature birth can not be defined, but a set of risk factors is considered, divided into three main groups of etiological factors: socio-economic, medical-biological, and behavioral. Associated with preterm birth socio-economic and behavioral risk factors include poverty, unemployment, low education, poor prenatal care, harmful habits such as smoking, alcohol, drugs and other harmful substances, unhealthy family environment, severe and prolonged stress, excessive physical exercise (lifting weights), trauma (hits or violence), new pregnancies less than 6 months after previous birth, unhealthy diet and low mother BMI, etc. Essential for the preterm birth is also the medico - biological etiological factors. One of these is uterine enlargement, as the main reason for this may be the presence of: multiple pregnancies that occurred naturally or after using assisted reproductive technologies or polyhydramnios (increased amount of amniotic fluid). Other risk factors include: placenta previa, incorrect position of the fetus, myoma, uterine cervix malformations (including cerebrovascular insufficiency), preeclampsia, uterine contractions, acute infections during pregnancy (vaginal - chlamydia, trichomonas, mycoplasma , toxoplasmosis, bacterial vaginosis, viral rubella, cytomegalovirus, herpes, influenza, adenovirus infection, chronic diseases (hypertension, cardiovascular diseases, diseases of the lungs, liver or kidney anemia and etc.), genetic factors, previous premature birth, etc. These risk indicators are subject to detailed analysis in the work of a number of authors. To limit preterm births, a number of studies have been conducted to identify and identify the risk factors that are relevant to it. Identifying and recognizing their effects and impact leading to premature birth will significantly reduce the severe health, economic and social consequences as well as reduce the risk of neonatal death. In order to reduce the frequency of preterm births, adequate and specialized prenatal care is essential. They must be individually tailored for each particular case of pregnancy and take into account the complex of risk predispositions.

2004 ◽  
Vol 20 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Vânia Maria de Farias Aragão ◽  
Antônio Augusto Moura da Silva ◽  
Lívia Farias de Aragão ◽  
Marco Antônio Barbieri ◽  
Heloísa Bettiol ◽  
...  

Preterm birth continues to be one of the main causes of neonatal morbidity and mortality. The objective of the present study was to identify risk factors for preterm birth in São Luís, Maranhão, Brazil. The sample consisted of hospital births at 10 public and private hospitals from March 1, 1997 to February 28, 1998. A total of 2,443 live births were randomly selected, excluding multiple deliveries and stillbirths. Preterm birth rate in São Luís was 12.7%. Risk factors for preterm delivery were maternal age below 18 years, family income equal to or less than one minimum wage/ month, primiparity, vaginal delivery at a public hospital, single mothers (or living without a partner), and absence of prenatal care. The following factors remained associated with preterm birth after multivariate analysis to control for confounding: maternal age below 18 years (OR = 1.9), primiparity (OR = 1.5), and failure to appear for scheduled prenatal care visits (OR = 1.5).


2016 ◽  
Vol 6 (2) ◽  
pp. 01 ◽  
Author(s):  
Vanessa Andréia Wachholz ◽  
Melissa Guterres Costa ◽  
Nalú Pereira da Costa Kerber ◽  
Carla Vitola Gonçalves ◽  
Diego Vasconcelos Ramos ◽  
...  

A prematuridade é um dos grandes problemas de saúde pública, por contribuir fortemente para a elevada taxa de morbimortalidade infantil. Possíveis fatores de risco que colaboram para sua ocorrência têm sido investigados, dentre eles a assistência pré-natal, pois a mesma é elencada em virtude de, por meio dela, ser possível prevenir, diagnosticar e tratar eventos indesejáveis que possam resultar em danos para mãe e o recém-nascido. Objetivou-se identificar a produção cientifica sobre a associação entre a prematuridade e a qualidade da assistência pré-natal. Revisão integrativa com coleta de dados realizada de março a junho de 2014 utilizando o descritor trabalho de parto prematuro nas bases de dados Scientific Eletronic Library Online e Literatura Internacional em Ciências da Saúde. Os artigos foram organizados conforme o assunto abordado, sendo criadas três categorias: fatores de risco para o parto prematuro, prevenção ao parto prematuro e assistência pré-natal e parto prematuro. Embora tenham sido encontrados poucos estudos relacionando o parto prematuro e a realização do pré-natal, cabe ressaltar a importância da realização de uma assistência pré-natal adequada, de acordo com o que o Ministério da Saúde preconiza por meio de uma rotina mínima. Ela é importante para detectar e tratar precocemente determinadas complicações que levam, entre outros desfechos indesejáveis, ao parto prematuro. Relationship between the quality of service pre -natal and a prematurity: An integrative reviewAbstract: Prematurity is a one of the major problem of public health, for contributing to the high rate of infant morbidity and mortality. Possible risk factors that collaborate to their occurrence have been investigated, including prenatal assistance, because through it, be possible to prevent, diagnose and treat adverse events that may result in damage to mother and the newborn. The objective identify the scientific production on the association between prematurity and the quality of prenatal care. Integrative review with data collection carried out from March to June 2014 using the descriptor preterm labor in databases Scientific Electronic Library Online and International Literature on Health Sciences. The articles were organized according to the subject matter, being created three categories: risk factors for preterm birth, preterm labor prevention and prenatal care and preterm birth. Although they have been found few studies relating the premature birth and the completion of prenatal care, it is important to stress the importance of a proper prenatal care, according to the Ministry of Health recommends using a minimum routine. It is important to detect and treat early certain complications that lead, among other undesirable outcomes, to premature birth.


2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.


2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110346
Author(s):  
Techane Sisay Tuji ◽  
Addisu Dabi Wake ◽  
Gezahegn Badeg Adere ◽  
Aselefu Beka Wedajo ◽  
Batu Dekeba Obole ◽  
...  

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.


Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Alexandra Stein ◽  
Nicolai Maass ◽  
Alexander Strauss ◽  
...  

Abstract According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. We aimed to establish how fetal gender and smoking interact with regard to perinatal outcomes, especially preterm delivery. Data from 220,339 singleton pregnancies, obtained from the German Perinatal Survey in Schleswig-Holstein and registered between 2004 and 2017 were analyzed in regard to smoking behavior, fetal gender, and preterm delivery. The rate of preterm births was directly proportional to the women’s consumption of nicotine. The rate of preterm deliveries was 6.8% among nonsmokers, and 13.2% in women who were very heavy smokers (≥22 cigarettes/day). Very heavy smoking (≥22 cigarettes/day) had a marked impact on extremely preterm births (<28 weeks of gestation) and very preterm births (28–31 weeks of gestation). Preterm births increased by 1.2% from heavy smokers to very heavy smokers; the differences between the other groups ranged between 0.1% and 0.4%. Fetal gender also had an impact on preterm birth: male infants were predominant in nearly all groups of women who delivered preterm infants. Smoking during pregnancy and male gender are both risk factors for preterm delivery. Fetal gender should be given greater attention as one of the several risk factors of preterm birth. Due to the high rate of morbidity among preterm infants and enormous costs for the healthcare system, women should be encouraged to cease or at least reduce smoking during pregnancy.


2018 ◽  
pp. 104-107
Author(s):  
A.S. Mandrykova ◽  

The objective: reduction of the frequency of perinatal complications in women with early preterm labor after the ART, based on the improvement and implementation of the algorithm for diagnostic and therapeutic and prophylactic measures. Materials and methods.We analyzed the course of 130 single-pregnancy pregnancy women with restored fertility after the use of therapeutic assisted reproductive technologies programs that ended with early premature births. The study of the subpopulation composition of lymphocytes and the content of activation markers of peripheral blood lymphocytes was performed using the method of quadratic color laser flow cytometry and a set of monoclonal antibodies. The concentration of cytokines IFN- γ, IL-4, IL-17A, IL-17F, IL-21 and IL-22 in serum of pregnant women was determined by solid-phase immunoassay analysis. The material for studying and analyzing the morpho-functional state of the fetoplacental complex was the results of pathomorphological study of the litter in all cases of early premature birth. By our own research, we established the frequency, structure and leading causes of early premature birth after assisted reproductive technologies, optimized the tactics of conducting induced pregnancies of high obstetric risk, formulated practical recommendations for implementation in practical medicine of Ukraine. Results. For introduction into practical medicine of Ukraine with the purpose of decreasing the frequency of perinatal complications and effective provision of obstetric and gynecological care, we recommend that the following provisions be included in the clinical protocol for the management of pregnancy of high obstetric risk in women after assisted reproductive technologies: 1. To predict the risk of early premature birth in women after ancillary reproductive technologies, the diagnostic algorithm should additionally include the definition of the main indicators of the serum cytokine profile: proinflammatory serum cytokines IFN- γ, IL-2, IL-12, IL-18; anti-inflammatory regulatory cytokine IL-10; quantitative indicators of NK cells with the phenotype CD3-CD16+CD56+, CD94+ lymphocytes and peripheral blood CD71 transferrin. 2. Use of medication correction – Micronized progesterone (200 mg/day). 3. At the gestational age of 28–33 weeks, with the premature rupture of the membranes optimal and effective is the expectant management of pregnancy for 5 days with subsequent delivery of women through the natural birth canal, which makes it possible to achieve the maximum possible degree of maturity of the fetus with a minimum risk of ascending infection in newborns. Conclusions. The effectiveness of our improved algorithm is a significant reduction in women after assisted reproductive technologies, early preterm labor (2.8 times), placental dysfunction (2.3 times), premature rupture of the membranes (in 2, 1 time), fetal distress (3,6 times), abdominal degeneration (2.9 times) and implementation of intraaminal infections (2.6 times; p<0.05). The total morbidity of newborns in the early neonatal period decreased 2.4 times, and perinatal losses were absent. Key words: assisted reproductive technologies, RPP, PRPO, markers of activation of lymphocytes, cytokines.


2019 ◽  
Vol 20 (17) ◽  
pp. 4169
Author(s):  
Marina La Rovere ◽  
Marica Franzago ◽  
Liborio Stuppia

About 1–4% of children are currently generated by Assisted Reproductive Technologies (ART) in developed countries. These babies show only a slightly increased risk of neonatal malformations. However, follow-up studies have suggested a higher susceptibility to multifactorial, adult onset disorders like obesity, diabetes and cardiovascular diseases in ART offspring. It has been suggested that these conditions could be the consequence of epigenetic, alterations, due to artificial manipulations of gametes and embryos potentially able to alter epigenetic stability during zygote reprogramming. In the last years, epigenetic alterations have been invoked as a possible cause of increased risk of neurological disorders, but at present the link between epigenetic modifications and long-term effects in terms of neurological diseases in ART children remains unclear, due to the short follow up limiting retrospective studies. In this review, we summarize the current knowledge about neurological disorders promoted by epigenetics alterations in ART. Based on data currently available, it is possible to conclude that little, if any, evidence of an increased risk of neurological disorders in ART conceived children is provided. Most important, the large majority of reports appears to be limited to epidemiological studies, not providing any experimental evidence about epigenetic modifications responsible for an increased risk.


Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.


2018 ◽  
Vol 5_2018 ◽  
pp. 44-49 ◽  
Author(s):  
Malgina G.B. Malgina ◽  
Fassakhova A.F. Fassakhova ◽  
Tretyakova T.B. Tretyakova ◽  
Brusnitsyna V.Yu. Brusnitsyna V ◽  
Rykosuev N.E. Rykosuev ◽  
...  

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