Epidemiology of preterm birth and its clinical subtypes

Ananth, Cande V.; Vintzileos, Anthony M.

doi:10.1080/14767050600965882

Cited by 388 publications

(335 citation statements)

References 77 publications

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“…Tubal ectopic pregnancy occurs in 1 in 80 pregnancies and remains a common cause of morbidity in early pregnancy and occasional mortality (Tay et al 2000). Preterm birth occurs in around 10% of all deliveries, and nearly 30% of preterm deliveries are associated with intrauterine infection (Ananth & Vintzileos 2006, Romero et al 2007.…”

Section: Introductionmentioning

confidence: 99%

Innate immunity and disorders of the female reproductive tract

Horne¹,

Stock²,

King³

2008

Reproduction

136

129

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Sexually transmitted infections, and their associated sequelae, such as tubal infertility, ectopic pregnancy and preterm labour, are a major worldwide health problem. Chlamydia trachomatis infection is thought to be the leading global cause of tubal infertility and tubal ectopic pregnancy. Preterm birth occurs in around 10% of all deliveries, and nearly 30% of preterm deliveries are associated with intrauterine infection. The mucosal innate immune system of the female reproductive tract has evolved to eliminate such sexually transmitted pathogens whilst maintaining its ability to accommodate specialized physiological functions that include menstruation, fertilization, implantation, pregnancy and parturition. The aim of this review was to describe the role and distribution of key mediators of the innate immune system, the natural antimicrobial peptides (secretory leukocyte protease inhibitor, elafin and the defensins) and the pattern recognition toll-like receptors in the normal female reproductive tract and in the context of these pathological processes.

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Section: Introductionmentioning

confidence: 99%

Innate immunity and disorders of the female reproductive tract

Horne¹,

Stock²,

King³

2008

Reproduction

136

129

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“…2,3 The cause of PTD can be identified in some cases, however the etiology in the majority of spontaneous PTD remains unknown. 4,5 Previous research has concentrated on the identification of medical, social and environmental variables; 5 however genetic predisposition toward PTD has been shown to be one of the strongest risk factors. 6 Women are more likely to deliver a preterm infant if they have had a prior PTD, if they themselves were born prematurely or if they have a sister who delivered a preterm child.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal variation in genes of cholesterol metabolism is associated with preterm delivery

et al. 2007

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Objective: To examine the contribution of variants in fetal and maternal cholesterol metabolism genes in preterm delivery (PTD).Study Design: A total of 40 single-nucleotide polymorphisms (SNPs) in 16 genes related to cholesterol metabolism were examined for 414 preterm infants (gestational ages 22 to 36 weeks; comprising 305 singletons and 109 twins) and at least 1 parent. Fetal effects were assessed using the transmission disequilibrium test (TDT) for each SNP, followed by a log linear model-based approach to utilize families with missing parental genotypes for those SNPs showing significance under TDT. Genetic variant effects were examined for a role in PTD, gestational age and birth weight. Maternal effects were estimated using a log linear model-based approach.Result: Among singleton gestations, suggestive association (P<0.01 without adjusting for multiple comparisons) was found between birth weight and fetal DHCR7 gene/SNP combinations (rs1630498, P ¼ 0.002 and rs2002064, P ¼ 0.003). Among all gestations, suggestive associations were found between PTD and fetal HMGCR (rs2303152, P ¼ 0.002) and APOA1 (rs 5070, P ¼ 0.004). The result for HMGCR was further supported by the log linear model-based test in the single births (P ¼ 0.007) and in all births (P ¼ 0.006). New associations (APOE and ABCA1) were observed when birth weight was normalized for gestational age suggesting independent effects of variants on birth weight separate from effects on PTD. Testing for maternally mediated genetic effects has identified suggestive association between ABCA1 (rs4149313, P ¼ 0.004) and decreased gestational age.Conclusion: Variants in maternal and fetal genes for cholesterol metabolism were associated with PTD and decreased birth weight or gestational age in this study. Genetic markers may serve as one mechanism to identify high-risk mothers and fetuses for targeted nutritional treatment and/or prevention of low birth weight or PTD.

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“…3 One-half of twins and nearly all triplets are born prematurely. 3,4 A greater understanding of factors that contribute to preterm labor in multiple gestations is necessary to provide appropriate counseling and for developing effective monitoring and treatment plans.…”

Section: Introductionmentioning

confidence: 99%

Effect of parity on gestational age at delivery in multiple gestation pregnancies

et al. 2008

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Objective: To estimate the effect of parity on gestational age (GA) at birth in multifetal pregnancies.Study Design: Birth data from the public-access Matched Multiple Birth File produced by the National Center for Health Statistics from 1995 to 2000 were analyzed following IRB approval. GA, parity and demographic data were analyzed with parametric and nonparametric tests, including regression analysis, using SPSS.Result: Data from women with twin (n ¼ 316 983), triplet (n ¼ 11 981), and quadruplet (n ¼ 766) pregnancies were analyzed. A significantly higher proportion of nulliparous versus parous women were Caucasian (twins: 82 versus 77%; triplets: 91 versus 87%) and had more than 15 years of education (twins: 39 versus 24%; triplets: 55 versus 39%; quadruplets: 53 versus 35%). Mean GA was 5.6 days longer for twins, 5.4 days longer for triplets and 6.8 days longer for quadruplets born to parous versus nulliparous women. Caucasian and African-American parous women pregnant with twins or triplets delivered their babies at a later GA than their nulliparous counterparts at each level of education. GA at delivery increased as a function of age of the mother in nulliparous and parous women of twins or triplets, and at every age level, parous women delivered their babies at a later GA. A higher proportion of nulliparous women delivered before 24 weeks (twins: 2.9 versus 1.2%; triplets: 5.9 versus 2.5%; quadruplets: 8.3 versus 2.6%). The percentage of twins born at or after 32 weeks was 84.9% for nullipara and 90.1% for parous women; for triplets, corresponding figures were 61.4 and 69.6%; and for quadruplets the figures were 33.2 and 44.2%. The percentage of births at or after 36 weeks for nulliparous and parous women pregnant with twins was 54.8 and 63.2%, respectively. The majority of the gain in GA was observed between women who had no previous births and those who had one previous birth. In regression analysis, the effect of parity remained after controlling for demographic and risk factors known to affect GA.Conclusion: GA at delivery is significantly increased in parous women carrying a multifetal gestation after controlling for other factors that affect GA at birth.

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Epidemiology of preterm birth and its clinical subtypes

Cited by 388 publications

References 77 publications

Innate immunity and disorders of the female reproductive tract

Innate immunity and disorders of the female reproductive tract

Maternal and fetal variation in genes of cholesterol metabolism is associated with preterm delivery

Effect of parity on gestational age at delivery in multiple gestation pregnancies

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