المؤلفون: Pambet, Mathilde¹ (AUTHOR), Sirodot, Fanny¹ (AUTHOR), Pereira, Bruno² (AUTHOR), Cahierc, Romain¹ (AUTHOR), Delabaere, Amélie^1,3 (AUTHOR), Comptour, Aurélie¹ (AUTHOR), Rouzaire, Marion¹ (AUTHOR), Sapin, Vincent^4,5 (AUTHOR), Gallot, Denis^1,5 (AUTHOR) dgallot@chu-clermontferrand.fr

المصدر: Journal of Clinical Medicine. Sep2023, Vol. 12 Issue 17, p5707. 11p.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *UNIVERSITY hospitals, *FIBRONECTINS, *LONGITUDINAL method

مصطلحات جغرافية: CLERMONT-Ferrand (France)

مستخلص: We conducted a prospective double-blind study to compare two vaginal diagnostic methods in singleton pregnancies with threatened preterm labor (TPL) at the University Hospital of Clermont-Ferrand (France) from August 2018 to December 2020. Our main objective was to compare the diagnostic capacity at admission, in terms of positive predictive value (PPV) and negative predictive value (NPV), of Premaquick® (combined detection of IL-6/total IGFBP-1/native IGFBP-1) and QuikCheck fFN™ (fetal fibronectin) for delivery within 7 days in cases of TPL. We included 193 patients. Premaquick® had a sensitivity close to 89%, equivalent to QuikCheck fFN™, but a higher statistical specificity of 49.5% against 38.6% for QuikCheck fFN™. We found no superiority of Premaquick® over QuickCheck fFN™ in terms of PPV (6.6% vs. 7.9%), with NPV being equivalent in predicting childbirth within 7 days in cases of TPL (98.6% vs. 98.9%). Nevertheless, the combination of positive native and total IGFBP-1 and the combination of all three positive markers were associated with a higher PPV. Our results, though non-significant, support this combined multiple-biomarker approach to improve testing in terms of predictive values. [ABSTRACT FROM AUTHOR]

المؤلفون: Ünal, Canan, Tanaçan, Atakan, Fadiloğlu, Erdem, Çağan, Murat, Yücesoy, Halise Meltem, Beksaç, Mehmet Sinan

المصدر: Journal of the Turkish-German Gynecological Association; Dec2023, Vol. 24 Issue 4, p241-245, 5p

مصطلحات موضوعية: OBSTRUCTIVE lung disease diagnosis, ECHOCARDIOGRAPHY, CHILDBIRTH, STATURE, LENGTH of stay in hospitals, PNEUMONIA, ACADEMIC medical centers, BODY weight, PERICARDIAL effusion, PREGNANT women, RETROSPECTIVE studies, MANN Whitney U Test, GESTATIONAL age, PREGNANCY outcomes, VITAL capacity (Respiration), PREECLAMPSIA, RISK assessment, SCOLIOSIS, SYMPTOMS, PULMONARY function tests, DESCRIPTIVE statistics, CHI-squared test, BIRTH weight, FORCED expiratory volume, HOSPITAL care, PUERPERIUM, DATA analysis software, CESAREAN section, LONGITUDINAL method, PREMATURE labor

مصطلحات جغرافية: TURKEY

مستخلص: Objective: To demonstrate the impact of scoliosis on pregnancy and gestational outcome. Material and Methods: We retrospectively evaluated gestational outcomes of pregnant women with scoliosis at Hacettepe University Hospital between 2008 and 2018. Cases were grouped according to the presence of previous scoliosis surgery and compared in terms of gestational week at birth, birthweight, rate of neonatal intensive care unit admission, hospitalization during pregnancy, route of delivery, type of anesthesia at labor and postpartum intensive care unit admission rate. Ejection fraction (EF), functional vital capacity (FVC), forced expiratory volume (FEV1) and FEV1/FVC ratio values were also recorded. Results: A total of 23 women were included, of whom 12 (52.2%) had a prior scoliosis surgery. One of the 23 (4.3%) cases was terminated due to respiratory problems, while the remaining 22 cases resulted in deliveries. The median gestational week at birth was 38.2 and the median birth weight was 3150 g. Median (range) maternal height was 143 (80-160) cm while median (range) maternal weight was 51 (35-86) kg. Three (13.6%) were diagnosed with restrictive lung disease. No significant difference was found between operated and non-operated groups in terms of respiratory function test results, cardiac EF and other related demographic and clinical features. Overall cesarean delivery rate was 63.6% (14/22) and cesarean section rate was significantly higher in the operated group (83.3% versus 40%) (p=0.04). Conclusion: Cesarean section rate was increased in this cohort of pregnancies in women with scoliosis and who had previous scoliosis surgery. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of the Turkish-German Gynecological Association is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Crump, Casey^1,2 (AUTHOR) casey.crump@mssm.edu, Friberg, Danielle³ (AUTHOR), Li, Xinjun⁴ (AUTHOR), Sundquist, Jan^1,2,4 (AUTHOR), Sundquist, Kristina^1,2,4 (AUTHOR)

المصدر: International Journal of Epidemiology. Dec2019, Vol. 48 Issue 6, p2039-2049. 11p.

مصطلحات موضوعية: *PREMATURE labor, *SLEEP apnea syndromes, *CHILDBIRTH, *GESTATIONAL age, *NEUROBEHAVIORAL disorders, *COMPARATIVE studies, *PREMATURE infants, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *RESEARCH funding, *EVALUATION research, *PROPORTIONAL hazards models

مصطلحات جغرافية: SWEDEN

مستخلص: Background: Preterm birth (gestational age <37 weeks) has previously been associated with cardiometabolic and neuropsychiatric disorders into adulthood, but has seldom been examined in relation to sleep disorders. We conducted the first population-based study of preterm birth in relation to sleep-disordered breathing (SDB) from childhood into mid-adulthood.Methods: A national cohort study was conducted of all 4 186 615 singleton live births in Sweden during 1973-2014, who were followed for SDB ascertained from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth in relation to SDB while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed for potential confounding by unmeasured shared familial factors.Results: There were 171 100 (4.1%) persons diagnosed with SDB in 86.0 million person-years of follow-up. Preterm birth was associated with increased risk of SDB from childhood into mid-adulthood, relative to full-term birth (39-41 weeks) [adjusted hazard ratio (aHR), ages 0-43 years: 1.43; 95% confidence interval (CI), 1.40, 1.46; P <0.001; ages 30-43 years: 1.40; 95% CI, 1.34, 1.47; P <0.001]. Persons born extremely preterm (<28 weeks) had more than 2-fold risks (aHR, ages 0-43 years: 2.63; 95% CI, 2.41, 2.87; P <0.001; ages 30-43 years: 2.22; 95% CI, 1.64, 3.01; P <0.001). These associations affected both males and females, but accounted for more SDB cases among males (additive interaction, P = 0.003). Co-sibling analyses suggested that these findings were only partly due to shared genetic or environmental factors in families.Conclusions: Preterm-born children and adults need long-term follow-up for anticipatory screening and potential treatment of SDB. [ABSTRACT FROM AUTHOR]

المؤلفون: Levin, Heather I.^1,2 heather.levin@gmail.com, Sciscione, Anthony³, Ananth, Cande V.^1,4, Drassinower, Daphnie^1,5, Obican, Sarah G.^1,6, Wapner, Ronald J.¹

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Aug2018, Vol. 31 Issue 16, p2136-2140. 5p.

مصطلحات موضوعية: *PREMATURE labor, *PREGNANCY complications, *LABOR complications (Obstetrics), *PREMATURE infants, *CHILDBIRTH, *BED rest, *GESTATIONAL age, *LONGITUDINAL method, *ACTIVITIES of daily living

مستخلص: Purpose: We sought to determine whether activity restriction (AR) in a cohort of women at high risk for preterm delivery is associated with the risk of preterm delivery.Materials and Methods: This is a secondary analysis of the Maternal-Fetal Medicine Units MFMU's Preterm Prediction Study; a multicenter prospective cohort study designed to identify risk factors of preterm birth (PTB). The study group consisted of women with a singleton gestation that at their first study visit (23-24 weeks) had at least one of the following criteria: patient reported contractions, severe back pain, a cervical length <15 mm, spotting, protruding membranes, or positive fetal fibronectin. Women were assessed for AR at a 27- to 29-week study visit. Associations between AR and preterm delivery (<37 weeks) were examined through logistic regression models before and after adjustment for confounders.Results: Of the 1086 women that met the inclusion criteria, 16.5% (n = 179) delivered preterm. In this cohort, 9.7% (n = 105) of women were recommended AR, with 37.1% (n = 39) having a PTB. In the group not recommended AR (n = 981), 14.3% (n = 140) delivered preterm.Conclusion: In this cohort of women at high risk for PTB, activity restriction was associated with an increased risk of PTB. The use of AR in this population should be discouraged. [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: Berezowsky, Alexandra¹ (AUTHOR), Mazkereth, Ram² (AUTHOR), Ashwal, Eran¹ (AUTHOR), Mazaki-Tovi, Shali¹ (AUTHOR), Schiff, Eyal¹ (AUTHOR), Weisz, Boaz¹ (AUTHOR), Lipitz, Shlomo¹ (AUTHOR), Yinon, Yoav¹ (AUTHOR) yoav.yinon27@gmail.com

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Apr2016, Vol. 29 Issue 8, p1252-1256. 5p.

مصطلحات موضوعية: *TWINS, *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *DURATION of pregnancy, *GESTATIONAL age, *HOSPITAL admission & discharge, *HYPOTHERMIA, *PREMATURE infants, *NEONATAL jaundice, *LONGITUDINAL method, *MULTIPLE pregnancy, *NEONATAL intensive care, *OXYGEN therapy, *PATIENTS, *PHOTOTHERAPY, *RESPIRATORY distress syndrome, *NEONATAL intensive care units, *RETROSPECTIVE studies

مصطلحات جغرافية: ISRAEL

مستخلص: Objective: To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies.Methods: A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and 37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups.Results: Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort.Conclusions: The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation. [ABSTRACT FROM AUTHOR]

المؤلفون: Litwinska, E., Syngelaki, A., Cimpoca, B., Sapantzoglou, I., Nicolaides, K. H.

المصدر: Ultrasound in Obstetrics & Gynecology; Feb2020, Vol. 55 Issue 2, p189-197, 9p

مصطلحات موضوعية: PREGNANCY, LASER endoscopy, CHILDBIRTH, PREGNANCY tests, PREMATURE labor, RESEARCH, PREMATURE infants, RESEARCH methodology, FETAL development, TWINS, RETROSPECTIVE studies, GESTATIONAL age, MEDICAL cooperation, EVALUATION research, PREGNANCY outcomes, RISK assessment, PERINATAL death, COMPARATIVE studies, BIRTH weight, RESEARCH funding, MULTIPLE pregnancy, FETAL ultrasonic imaging, SMALL for gestational age, LONGITUDINAL method

مستخلص: Objective: To investigate the value of intertwin discordance in fetal crown-rump length (CRL) at the 11-13-week scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies.Methods: This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routine ultrasound examination at 11-13 weeks' gestation between 2002 and 2019. In pregnancies with no major abnormalities, we examined the value of intertwin discordance in fetal CRL in DC, MCDA and MCMA twins in the prediction of fetal loss at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm delivery at < 32 and < 37 weeks, birth of at least one small-for-gestational-age (SGA) neonate with birth weight < 5th percentile and intertwin birth-weight discordance of ≥ 20% and ≥ 25%.Results: First, the study population of 6225 twin pregnancies included 4896 (78.7%) DC, 1274 (20.4%) MCDA and 55 (0.9%) MCMA twin pregnancies. Second, median CRL discordance in DC twin pregnancies (3.2%; interquartile range (IQR), 1.4-5.8%) was lower than in MCDA twins (3.6%; IQR, 1.6-6.2%; P = 0.0008), but was not significantly different from that in MCMA twins (2.9%; IQR, 1.2-5.1%; P = 0.269). Third, compared to CRL discordance in DC twin pregnancies with two non-SGA live births at ≥ 37 weeks' gestation, there was significantly larger CRL discordance in both DC and MCDA twin pregnancies complicated by fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 32 and < 37 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, and in MCDA twin pregnancies undergoing endoscopic laser surgery. Fourth, the predictive performance of CRL discordance for each adverse pregnancy outcome was poor, with areas under the receiver-operating-characteristics curves ranging from 0.533 to 0.624. However, in both DC and MCDA twin pregnancies with large CRL discordance, there was a high risk of fetal loss. Fifth, in DC twin pregnancies, the overall rate of fetal loss at < 20 weeks' gestation was 1.3% but, in the small subgroup with CRL discordance of ≥ 15%, which constituted 1.9% of the total, the rate increased to 5.3%. Sixth, in MCDA twin pregnancies, the rate of fetal loss or endoscopic laser surgery at < 20 weeks was about 11%, but, in the small subgroups with CRL discordance of ≥ 10%, ≥ 15% and ≥ 20%, which constituted 9%, < 3% and < 1% of the total, the risk was increased to about 32%, 49% and 70%, respectively. Seventh, in MCMA twin pregnancies, there were no significant differences in CRL discordance for any of the adverse outcome measures, but this may be the consequence of the small number of cases in the study population.Conclusions: In both DC and MCDA twin pregnancies, increased CRL discordance is associated with an increased risk of fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 37 and < 32 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, but CRL discordance is a poor screening test for adverse pregnancy outcome. However, in DC twins, CRL discordance of ≥ 15% is associated with an increased risk of fetal loss at < 20 and < 24 weeks' gestation and, in MCDA twins, CRL discordance of ≥ 10%, and more so discordance of ≥ 15% and ≥ 20%, is associated with a very high risk of fetal loss or endoscopic laser surgery at < 20 and < 24 weeks and this information is useful in counseling women and defining the timing for subsequent assessment and possible intervention. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

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المؤلفون: Levin, Heather I., Sciscione, Anthony, Ananth, Cande V., Drassinower, Daphnie, Obican, Sarah G., Wapner, Ronald J.

المصدر: Journal of Maternal-Fetal & Neonatal Medicine; Aug2018, Vol. 31 Issue 16, p2136-2140, 5p

مصطلحات موضوعية: PREMATURE labor, PREGNANCY complications, LABOR complications (Obstetrics), PREMATURE infants, CHILDBIRTH, BED rest, GESTATIONAL age, LONGITUDINAL method, ACTIVITIES of daily living

مستخلص: Purpose: We sought to determine whether activity restriction (AR) in a cohort of women at high risk for preterm delivery is associated with the risk of preterm delivery.Materials and Methods: This is a secondary analysis of the Maternal-Fetal Medicine Units MFMU's Preterm Prediction Study; a multicenter prospective cohort study designed to identify risk factors of preterm birth (PTB). The study group consisted of women with a singleton gestation that at their first study visit (23-24 weeks) had at least one of the following criteria: patient reported contractions, severe back pain, a cervical length <15 mm, spotting, protruding membranes, or positive fetal fibronectin. Women were assessed for AR at a 27- to 29-week study visit. Associations between AR and preterm delivery (<37 weeks) were examined through logistic regression models before and after adjustment for confounders.Results: Of the 1086 women that met the inclusion criteria, 16.5% (n = 179) delivered preterm. In this cohort, 9.7% (n = 105) of women were recommended AR, with 37.1% (n = 39) having a PTB. In the group not recommended AR (n = 981), 14.3% (n = 140) delivered preterm.Conclusion: In this cohort of women at high risk for PTB, activity restriction was associated with an increased risk of PTB. The use of AR in this population should be discouraged. [ABSTRACT FROM AUTHOR]

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المؤلفون: Shachar, BZ, Mayo, JA, Lyell, DJ, Baer, RJ, Jeliffe‐Pawlowski, LL, Stevenson, DK, Shaw, GM

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology; Nov2016, Vol. 123 Issue 12, p2009-2017, 9p

مصطلحات موضوعية: PREGNANCY, PREGNANCY complications, CHILDBIRTH, MOTHER-child relationship, PREMATURE labor, ABORTION, BIRTH intervals, COMPARATIVE studies, GESTATIONAL age, PREMATURE infants, INFANT mortality, LONGITUDINAL method, MATERNAL age, RESEARCH methodology, EVALUATION of medical care, MEDICAL cooperation, OBESITY, PERINATAL death, RESEARCH, EVALUATION research, BODY mass index, DISEASE incidence, RETROSPECTIVE studies

مصطلحات جغرافية: CALIFORNIA

مستخلص: Objectives: We assessed whether interpregnancy interval (IPI) length after live birth and after pregnancy termination was associated with preterm birth (PTB).Design: Multiyear birth cohort.Settings: Fetal death, birth and infant death certificates in California merged with Office of Statewide Health Planning and Development.Population: One million California live births (2007-10) after live birth and after pregnancy termination.Methods: Logistic regression was used to estimate odds ratios (ORs) of PTB of 20-36 weeks of gestation and its subcategories for IPIs after a live birth and after a pregnancy termination. We used conditional logistic regression (two IPIs/mother) to investigate associations within mothers.Main Outcome Measure: PTB relative to gestations of ≥ 37 weeks.Results: Analyses included 971 211 women with IPI after live birth, and 138 405 women with IPI after pregnancy termination with 30.6% and 74.6% having intervals of <18 months, respectively. IPIs of <6 months or 6-11 months after live birth showed increased odds of PTB adjusted ORs for PTB of 1.71 (95% CI 1.65-1.78) and 1.20 (95% CI 1.16-1.24), respectively compared with intervals of 18-23 months. An IPI >36 months (versus 18-23 months) was associated with increased odds for PTB. Short IPI after pregnancy termination showed a decreased OR of 0.87 (95% CI 0.81-0.94). The within-mother analysis showed the association of increased odds of PTB for short IPI, but not for long IPI.Conclusions: Women with IPI <1 or >3 years after a live birth were at increased odds of PTB-an important group for intervention to reduce PTB. Short IPI after pregnancy termination was associated with reduced odds for PTB and needs to be further explored.Tweetable Abstract: Short and long IPI after live birth, but not after pregnancy termination, showed increased odds for PTB. [ABSTRACT FROM AUTHOR]

: Copyright of BJOG: An International Journal of Obstetrics & Gynaecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Dahlin, S, Gunnerbeck, A, Wikström, A‐K, Cnattingius, S, Edstedt Bonamy, A‐K

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology; Nov2016, Vol. 123 Issue 12, p1938-1946, 9p

مصطلحات موضوعية: HEALTH of mothers, TOBACCO & health, PREMATURE labor, DELIVERY (Obstetrics), CHILDBIRTH, GESTATIONAL age, PREMATURE infants, LONGITUDINAL method, SMOKING, DISEASE prevalence

مصطلحات جغرافية: SWEDEN

مستخلص: Objective: To study the associations of maternal tobacco use (smoking or use of snuff) and risk of extremely preterm birth, and if tobacco cessation before antenatal booking influences this risk. To study the association between tobacco use and spontaneous or medically indicated onset of delivery.Design: Population-based cohort study.Setting: Sweden.Population: All live singleton births, registered in the Swedish Medical Birth Register, 1999-2012.Methods: Odds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis.Main Outcome Measures: Extremely preterm birth (<28 weeks of gestation), very preterm birth (28-31 weeks), moderately preterm birth (32-36 weeks).Results: Maternal snuff use (OR 1.58; 95% CI: 1.14-2.21) and smoking (OR 1.61; 95% CI: 1.39-1.87 and OR 1.91; 95% CI: 1.53-2.39 for moderate and heavy smoking, respectively) were associated with an increased risk of extremely preterm birth. When cessation of tobacco use was obtained there was no increased risk of preterm birth. Snuff use was associated with a twofold risk increase of medically indicated extremely preterm birth, whereas smoking was associated with increased risks of both medically indicated and spontaneous extremely preterm birth.Conclusions: Snuff use and smoking in pregnancy were associated with increased risks of extremely preterm birth. Women who stopped using tobacco before the antenatal booking had no increased risk. These findings indicate that nicotine, the common substance in cigarettes and snuff, is involved in the mechanisms behind preterm birth. The use of nicotine should be minimized in pregnancy.Tweetable Abstract: Tobacco use increases risk of extremely preterm birth. Cessation is preventive. Avoid nicotine in pregnancy. [ABSTRACT FROM AUTHOR]

: Copyright of BJOG: An International Journal of Obstetrics & Gynaecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)