المؤلفون: Minissian, Margo B.^1,2,3 MinissianM@cshs.org, Kilpatrick, Sarah⁴, Eastwood, Jo-Ann³, Robbins, Wendie A.³, Accortt, Eynav E.⁴, Wei, Janet¹, Shufelt, Chrisandra L.¹, Doering, Lynn V.³, Bairey Merz, C. Noel¹, Merz, C Noel Bairey⁵ (AUTHOR)

المصدر: Circulation. 2/20/2018, Vol. 137 Issue 8, p865-871. 7p. 1 Chart.

مصطلحات موضوعية: *PREMATURE labor, *CARDIOVASCULAR diseases risk factors, *CHILDBIRTH, *PREGNANCY, *MATERNAL mortality, *VASCULAR diseases, *CARDIOVASCULAR diseases in pregnancy, *CARDIOVASCULAR system physiology, *ENDOTHELIUM, *RESEARCH funding

مستخلص: Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman's cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a ≤3-fold increased risk of maternal CVD death later in life compared with having a term delivery. This review focuses on 3 key areas to critically assess the association of sPTD and future maternal CVD risk: (1) CVD risk factors, (2) inflammatory biomarkers of interest, and (3) specific forms of vascular dysfunction, such as endothelial function and arterial stiffness, and mechanisms by which each may be linked to sPTD. The association of sPTD with subsequent future maternal CVD risk suggests that a woman's abnormal response to pregnancy may serve as her first physiological stress test. These findings suggest that future research is needed to understand why women with sPTD may be at risk for CVD to implement effective interventions earlier in a woman's life. [ABSTRACT FROM AUTHOR]

المؤلفون: Gillespie, Shannon L.¹ gillespie.175@osu.edu, Neal, Jeremy L.², Christian, Lisa M.^3,4, Szalacha, Laura A.⁵, Mccarthy, Donna O.⁶, Salsberry, Pamela J.⁷

المصدر: Nursing Research. Mar/Apr2017, Vol. 66 Issue 2, p95-104. 10p.

مصطلحات موضوعية: *RISK factors in premature labor, *PREMATURE infants, *ALLELES, *BLACK people, *CELL receptors, *CHI-squared test, *CHILDBIRTH, *CONCEPTUAL structures, *CONFIDENCE intervals, *CYTOKINES, *FISHER exact test, *GENETIC polymorphisms, *INTERLEUKIN-1, *INTERVIEWING, *LONGITUDINAL method, *RACE, *REGRESSION analysis, *RESEARCH funding, *STATISTICS, *T-test (Statistics), *TIME, *DATA analysis, *DATA analysis software, *DESCRIPTIVE statistics, *NUCLEIC acid amplification techniques, *GENOTYPES, *PREVENTION

مستخلص: Background: Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variables remain unclear. Evidence also suggests that inflammatory pathways differ by race; however, studies among African American women are lacking. Objectives: We assessed whether an IL1RN variant was associated with timing of birth among African American women and whether this relationship was mediated by lower anti-inflammatory IL-1Ra production or related to a decrease in inhibition of proinflammatory IL-1β production. Methods: A candidate gene study using a prospective cohort design was used. We collected blood samples at 28-32 weeks of gestation among African American women experiencing an uncomplicated pregnancy (N = 89). IL1RN single-nucleotide polymorphism (SNP) rs2637988 was genotyped, and lipopolysaccharide-stimulated IL-1Ra and IL-1β production was quantified. Medical record review determined timing of birth. Results: Women with GG genotype gave birth earlier than women with AA/AG genotypes (b* =.21, p = .04). There was no indirect effect of IL1RN SNP rs2637988 allele status on timing of birth through IL-1Ra production, as evidenced by a nonsignificant product of coefficients in mediational analyses (ab = .006, 95% CI [-0.05, 0.13]). Women with GG genotype showed less inhibition of IL-1β production for a unit positive difference in IL-1Ra production than women with AA/AG genotypes (b* = .93, p = .03). Greater IL-1β production at 28-32 weeks of pregnancy was marginally associated with earlier birth (b* =.21, p = .05). Discussion: Women with GG genotype may be at risk for earlier birth because of diminished IL-1β inhibition, allowing for initiation of a robust inflammatory response upon even mild immune challenge. Study of inflammatory contributions to early birth among African American women may be key to identifying potential prognostic markers of risk and targeted preventive interventions. [ABSTRACT FROM AUTHOR]

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: Bailey, Beth A.¹ nordstro@etsu.edu, McCook, Judy G.¹, Chaires, Caitlyn¹

المصدر: Southern Medical Journal. Oct2014, Vol. 107 Issue 10, p624-629. 6p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *RURAL health, *CHILDBIRTH, NEWBORN infant health

مستخلص: Objectives: Infants delivered at >37 weeks' gestation are considered full term, but research has demonstrated those born at 37 to 38 weeks (early term) have a higher risk for poor birth outcomes than deliveries at 39 to 41 weeks (full term). Despite this, many deliveries occur elective (scheduled, no medical indication) before 39 weeks. This study examined the risks of elective early-term delivery in a disadvantaged, rural sample and compared these results with national findings. Methods: Data were available for 638 rural women, recruited prenatally from three counties in rural southern Appalachia, who delivered electively at >37 weeks. Results: Compared with electively delivered full-term infants, those delivered electively at early term were 7.7 times more likely to be lo birth weight, 4.4 times more likely to have a neonatal intensive care unit admission, and 2.5 times more likely to develop jaundice. Those living furthest from the hospital were most likely to deliver electively at <39 weeks. Although rates of elective deliveries <39 weeks were no higher than national rates, adjusted odds ratios (aOR) of associated admission to a neonatal intensive care unit doubled (aOR 4.4 vs aOR 2.2). Conclusions: Results demonstrate that initiatives targeting earlyterm elective deliveries are needed in rural, disadvantaged regions. [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.

المؤلفون: Baker, Victoria L.¹

المصدر: Nurse Practitioner. May2008, Vol. 33 Issue 5, p42-46. 5p. 1 Black and White Photograph, 1 Chart.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *PSYCHOLOGICAL stress, *INFECTION, *PATIENT education

مستخلص: The article presents an overview of preterm delivery including its causes and prevention. The causes of preterm delivery include stress, placental abruption, infection and uterine distension. Positive fetal fibronectin (fFN) and short cervical length are also positive indicators as concluded by the preterm prediction study. Patient education, follow up and referral are the key factors in the prevention of such occurrence.

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.