المؤلفون: Gyamfi-Bannerman, Cynthia^1,2,3 cg2231@cumc.columbia.edu, Ananth, Cande V.^1,2,3

المصدر: Obstetrics & Gynecology. Dec2014, Vol. 124 Issue 6, p1069-1074. 6p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *PREGNANCY, *CHILDBIRTH, *GESTATIONAL age, *OBSTETRICAL research

مصطلحات جغرافية: UNITED States

مستخلص: OBJECTIVE: For the first time in decades, the rate of U.S. preterm delivery has declined consistently since 2005. Recent nationwide policies enforcing elective delivery at or beyond 39 weeks of gestation suggest this decrease may be the result of changes in practice patterns; however, this is not known. Thus, we sought to evaluate whether the decline in preterm delivery was the result of a decrease in indicated or spontaneous preterm delivery and to assess this decrease by race and ethnicity. METHODS: This was a population-based retrospective analysis using U.S. vital statistics data restricted to singleton live births from 2005 to 2012. The main outcome measures were overall, indicated, and spontaneous pre-term delivery rates. Preterm deliveries were defined as births from 24 to 36 weeks of gestation. We used an algorithm to designate births as indicated or spontaneous. Gestational age was further grouped into early pre-term (24-31 weeks of gestation), moderate preterm (32-34 weeks of gestation), late preterm (34-36 weeks of gestation), early term (37-38 weeks of gestation), full term (39-40 weeks of gestation), late term (41 weeks of gestation), and postterm (42-44 weeks of gestation). Analyses were based on the best obstetric estimate of gestational age. RESULTS: Of 19,984,436 included births, the spontaneous preterm delivery rate declined by 15.4% between 2005 (5.3%) and 2012 (4.5%), whereas indicated preterm delivery rates declined by 17.2% (3.9 to 3.2%). The largest decline was in the postterm pregnancies (238.5%) followed by early term (219.1%), early preterm (217.1%), moderate preterm (212.4%), and late preterm (215.8%) with concurrent increases in full term (+14.3%) and late term (+18.7%) gestations. The patterns were similar across race groups. CONCLUSION: The noted decline in preterm delivery rates is accompanied by a concurrent decline in both spontaneous and indicated preterm deliveries of almost equal magnitudes. [ABSTRACT FROM AUTHOR]

المؤلفون: Tsai, Hui-Ju h-tsai@northwestern.edu, Hong, Xiumei, Chen, Jinbo, Liu, Xin, Pearson, Colleen, Ortiz, Katherin, Hirsch, Emmet, Heffner, Linda, Weeks, Daniel E., Zuckerman, Barry, Wang, Xiaobin

المصدر: Obstetrics & Gynecology. Nov2011, Vol. 118 Issue 5, p1081-1089. 9p.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *AFRICAN American women, *BIOMARKERS, *CYTOCHROME P-450, *GLUTATHIONE transferase

مستخلص: The article presents a study to determine if African ancestry can account for pre-term birth variance among African American women. It states that the study involved genotyping 1,509 markers for African ancestry among 1,030 women, such as cytochrome P450 101 (CYP1A1) and glutathione S-transferases Theta 1 (GSTT1). Cited findings show that African ancestry is a significant cause for pre-term birth variance, and suggests the need to find ways to better predict such cases.

المؤلفون: Laughon, S. Katherine¹ laughonsk@mail.nih.gov, Reddy, Uma M.¹, Liping Sun¹, Zhang, Jun¹

المصدر: Obstetrics & Gynecology. Nov2010, Vol. 116 Issue 5, p1047-1055. 9p. 4 Charts.

مصطلحات موضوعية: *PREMATURE labor, *NEONATAL diseases, *PERINATAL death, *CHILDBIRTH, *OBSTETRICAL research

مستخلص: This article present a study which characterized precursors for late preterm birth in singletons and incidences of neonatal diseases and perinatal deaths by gestational age and precursor. The study involves the use of retrospective observational data to compare 15,136 gestations born late preterm with 170,593 deliveries between 37 0/7 and 41 6/7 weeks. It was revealed that a significant number of late preterm births were potentially avoidable.

المؤلفون: Noehr, Bugge^1,2, Jensen, Allan^1,2, Frederiksen, Kirsten^1,2, Tabor, Ann^1,2, Kjaer, Susanne K.^1,2 susanne@cancer.dk

المصدر: Obstetrics & Gynecology. Dec2009, Vol. 114 Issue 6, p1232-1238. 7p.

مصطلحات موضوعية: *SURGICAL excision, *RISK factors in premature labor, *CERVIX uteri surgery, *RISK assessment, *CHILDBIRTH

مصطلحات جغرافية: DENMARK

مستخلص: The article presents a study which examines the depth of cervical cone excision procedure and its associated risk to preterm delivery. It states that the study includes all deliveries in Denmark from 1997-2005. It notes that 552, 678 spontaneous deliveries were eligible for analysis, 19, 049 or 3.5 percent of which were preterm. It shows that the increase in cone depth significantly associated with preterm delivery risk with 6 percent increase for every additional tissue excised.

المؤلفون: Chen, Aimin¹ aiminchen@creighton.edu, Feresu, Shingairai A.², Barsoom, Michael J.³

المصدر: Obstetrics & Gynecology. Sep2009, Vol. 114 Issue 3, p516-522. 7p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *NEONATAL death, *PREGNANCY, *CHILDBIRTH

مستخلص: The article presents the findings of the study regarding the heterogeneity of preterm labor, birth and preterm premature rupture of membranes (PROM) in neonatal death risk. The findings of the study which used 2001 U.S. linked birth/infant death data sets revealed that there were 3,763,306 singleton live births at 24-44 weeks of gestation period. The findings also revealed that preterm PROM, preterm labor and preterm birth had neonatal risk of 2.7%, 1.1% and 1.8% respectively.

المصدر: Obstetrics & Gynecology. Apr2007, Vol. 109 Issue 4, p1007-1018. 12p. 1 Chart.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *DELIVERY (Obstetrics), *CHILDBIRTH, *OBSTETRICS

مستخلص: The article focuses on premature rupture of membranes (PROM) which is a complication in about one third of preterm births. PROM is associated with a brief latency between membrane rupture and delivery, increased potential for perinatal infection and in utero umbilical cord compression. The article also deals with the optimal approaches to assessment and treatment of women with term and preterm PROM.

المؤلفون: Deulofeut, Richard¹, Sola, Augusto¹, Lee, Ben¹, Buchter, Susie¹, Rahman, Mostafizur¹, Rogido, Marta¹

المصدر: Obstetrics & Gynecology. Mar2005, Vol. 105 Issue 3, p525-531. 7p. 3 Charts.

مصطلحات موضوعية: *PREMATURE labor, *LOW birth weight, *FETAL growth retardation, *PREMATURE infant diseases, *DELIVERY (Obstetrics), *CHILDBIRTH, *OBSTETRICS

مستخلص: OBJECTIVE: To evaluate whether mode of delivery is a predictor of poor short-term outcome at different birth weight categories in very low birth weight infants. METHODS: This study examined a cohort of infants weighing less than 1,251 g horn at 2 perinatal centers from January 1, 2000, to December 31, 2003. Outborn infants or those with major anomalies were excluded from the study. Outcome variables included death, severe intraventricular hemorrhage, periventricular leukomalacia (PVL), and combined poor short-term outcomes (death, severe intraventricular hemorrhage, and PVL). RESULTS: Of the 397 infants who met enrollment criteria, 44% were born vaginally and 56% by cesarean delivery. The proportion of multiparous, breech presentation and prolonged rupture of membranes was significantly different between groups. For infants weighing less than 751 g, the risks of severe intraventricular hemorrhage (41% versus 22%; odds ratio [OR] 2.79, 95% confidence interval [CI] 1.08–7.72) and combined poor short-term outcome (67% versus 41%; OR 2.95, 95% CI 1.25–6.95) were significantly higher if delivered vaginally. Among survivors weighing less than 751 g, the risk of severe intraventricular hemorrhage was higher among those delivered vaginally (24% versus 9%; OR 8.18, 95% CI 1.58–42.20). In infants less 1,251 g who survived, vaginal delivery had a strong association with PVL (5% versus 1%; OR 11.53, 95% CI 1.66–125). CONCLUSION: In infants less than 1,251 g who survived to discharge, vaginal delivery is associated with higher risk for PVL. Furthermore, in infants less than 751 g, vaginal delivery is a predictor for severe intraventricular hemorrhage and combined poor short-term outcome. The negative impact of vaginal delivery mode decreases as birth weight category increases. [ABSTRACT FROM AUTHOR]

المؤلفون: Quiñones, Joanne N.^1,2,3,4 jquinones@mail.obgyn.upenn.edu, Stamilio, David M.^1,2,3,4, Paré, Emmanuelle^1,2,3,4, Peipert, Jeffrey F.^1,2,3,4, Stevens, Erika^1,2,3,4, Macones, George A.^1,2,3,4

المصدر: Obstetrics & Gynecology. Mar2005, Vol. 105 Issue 3, p519-524. 6p. 3 Charts.

مصطلحات موضوعية: *PREMATURE labor, *DURATION of pregnancy, *VAGINAL birth after cesarean, *CESAREAN section prevention, *DELIVERY (Obstetrics), *CHILDBIRTH, *OBSTETRICS

مستخلص: OBJECTIVE: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that preterm women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC. METHODS: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals. We collected information on demographics, medical and obstetric history, complications, and outcome of the index pregnancy. The primary analysis was limited to women with singleton gestations and one prior cesarean delivery. Statistical analysis consisted of bivariate and multivariable techniques. RESULTS: Among the 20,156 patients with one prior cesarean delivery, 12,463 (61%) attempted a VBAC. Mean gestational ages for the term and preterm women were 39.2 weeks and 33.9 weeks of gestation, respectively. The VBAC success rates for the term and preterm groups were 74% and 82%, respectively (P < .001). Multivariable analysis showed that the VBAC success was higher (adjusted odds ratio 1.54, 95% confidence interval 1.27–1.86) in preterm gestations. A decreased risk of rupture among preterm gestations was suggested in these results (adjusted odds ratio 0.28, 95% confidence interval 0.07–1.17; P = .08). CONCLUSION: Preterm patients undergoing a VBAC have higher success rates when compared with term patients undergoing a VBAC. Preterm patients undergoing VBAC may have lower uterine rupture rates. [ABSTRACT FROM AUTHOR]

المؤلفون: Quinn, Molly M.¹, Rosen, Mitchell P.¹, Huddleston, Heather G.¹, Cedars, Marcelle I.¹, Fujimoto, Victor Y.¹

المصدر: Obstetrics & Gynecology. Jul2018, Vol. 132 Issue 1, p115-121. 7p.

مصطلحات موضوعية: *CHILDBIRTH, *FERTILIZATION in vitro, *PREMATURE labor, *BODY mass index, *LOW birth weight

مستخلص: Objective: To describe the relationship between a short interpregnancy interval and adverse pregnancy outcomes in the population undergoing assisted reproductive technology.Methods: This is a retrospective analysis using data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. The cohort includes patients with a history of live birth from assisted reproductive technology who returned for a fresh, autologous in vitro fertilization (IVF) cycle from 2004 to 2013. Interpregnancy interval was defined as the interval from live birth to cycle start. Logistic regression models of preterm delivery (less than 37 weeks of gestation) and low birth weight (less than 2,500 g) on interpregnancy interval were fit with adjustment for age, body mass index, and history of preterm delivery. Predicted probabilities were generated from the logistic model.Results: Of 51,997 fresh IVF cycles after an index live birth, 17,536 resulted in a repeat live birth with 11,271 singleton live births from autologous IVF. An interpregnancy interval of less than 18 months occurred in 40.9% of cycles. Compared with a reference interpregnancy interval of 12 to less than 18 months, the adjusted odds ratio for singleton preterm delivery was 1.66 (95% CI 1.05-2.65) for an interpregnancy interval less than 6 months and 1.34 (95% CI 1.06-1.69) for 6 to less than 12 months. An interpregnancy interval 6 to less than 12 months was associated with a 3.0% increase in preterm delivery (13.6±1.1% vs 10.6±0.7%, P=.030) and a 2.7% increase in low birth weight (8.0±0.9% vs 5.3±0.5%, P=.025) compared with an interpregnancy interval of 12 to less than 18 months.Conclusion: In this nationally representative population, an interval from delivery to treatment start of less than 12 months is associated with increased rates of preterm delivery and low birth weight in singleton live births from assisted reproductive technology. The data support delaying the start of IVF treatment 12 months from a live birth, but do not suggest a benefit from a longer interval as has been recommended for naturally conceiving couples. [ABSTRACT FROM AUTHOR]

المؤلفون: Rossi, Robert M.¹, DeFranco, Emily A.²

المصدر: Obstetrics & Gynecology. Jul2018, Vol. 132 Issue 1, p107-114. 8p.

مصطلحات موضوعية: *CHILDBIRTH, *PREGNANCY, *PREMATURE labor, *CHORIOAMNIONITIS, *HYSTERECTOMY, RISK factors

مستخلص: Objective: To quantify the rate of maternal complications associated with a periviable birth in a contemporary population of live births in the state of Ohio.Methods: We conducted a population-based retrospective cohort study of all live births in Ohio (2006-2015). Maternal, obstetric, and neonatal characteristics were compared between women who delivered in the periviable period (20-25 weeks of gestation) with those who delivered preterm (26-36 weeks of gestation) and at term (greater than 36 weeks of gestation). Women were also stratified by 3-week gestational age epochs (ie, 20-22, 23-25 weeks of gestation). The primary study outcome was a composite of individual adverse maternal outcomes (chorioamnionitis, blood product transfusion, hysterectomy, unplanned operation, and intensive care unit [ICU] admission). Multivariate logistic regression estimated the relative association of periviable birth with maternal complications.Results: Of 1,457,706 live births in Ohio during the 10-year study period, 6,085 live births (0.4%) occurred during the periviable period (20-25 weeks of gestation). The overall rate of the composite adverse outcome was 17.2%. In multivariate analysis, periviable birth was associated with an increased risk of the composite adverse maternal outcome (adjusted relative risk [RR] 5.8, CI 5.4-6.2) and individual complications including transfusion (adjusted RR 4.4, CI 3.4-5.7), unplanned operative procedure (adjusted RR 2.0, CI 1.7-2.4), unplanned hysterectomy (adjusted RR 7.8, CI 4.6-13.0), uterine rupture (adjusted RR 7.1, CI 3.8-13.4), and ICU admission (adjusted RR 9.6, CI 7.2-12.7) compared with the term cohort. Delivery between 20-22 weeks and 23-25 weeks of gestation was associated with the highest risk of composite adverse outcome. The risk of composite adverse outcome decreased with advancing gestational age stratum.Conclusion: Periviable birth is associated with significant maternal morbidity. Nearly one in five women in this cohort had a serious morbidity associated with their periviable delivery. [ABSTRACT FROM AUTHOR]