Iatrogenic and spontaneous preterm birth in England: A population‐based cohort study

Aughey, Harriet; Jardine, Jennifer; Knight, Hannah; Gurol‐Urganci, Ipek; Walker, Kate; Harris, Tina; Meulen, Jan van der; Hawdon, Jane; Pasupathy, Dharmintra; Blotkamp, Andrea; Carroll, Fran; Coe, Megan; Dunn, George A.; Geary, Rebecca; Harvey, Alissa; Heighway, Emma; Khalil, Asma; Langham, Julia; Mamza, Lindsey; Müller, Patrick; Moitt, Natalie; Relph, Sophie; Thomas, E. Louise; Waite, Lara; Webster, Kirstin

doi:10.1111/1471-0528.17291

Cited by 6 publications

(4 citation statements)

References 28 publications

(74 reference statements)

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“…A complete case analysis is presented in the supplementary information for comparison (Additional file 8 : Table 6). We have been unable to differentiate between the different types of PTB (spontaneous versus medically indicated), which limits our ability to make assumptions on how each individual condition contributed or to theorise regarding causality [ 34 ]. Previous studies have reported racial and ethnic disparities in both the incidence of severe maternal morbidity and the prevalence of multimorbidity [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study

Azcoaga-Lorenzo,

Fagbamigbe,

Agrawal

et al. 2023

BMC Med

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Background Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB. Methods This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR). Results Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82). Conclusions Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed.

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Section: Discussionmentioning

confidence: 99%

Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study

Azcoaga-Lorenzo,

Fagbamigbe,

Agrawal

et al. 2023

BMC Med

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“…29 Indicated preterm birth was defined as preterm birth due to maternal or fetal indications. 30,31 The rate of GF cultures positive forUreaplasma spp. was compared between the study groups.…”

Section: Methodsmentioning

confidence: 99%

Analysis of gastric fluid in preterm newborns supports the view that the amniotic cavity is sterile before the onset of parturition: a retrospective cohort study

Lee

Choi

Shin

et al. 2023

Preprint

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Objective To compare the frequency of Ureaplasma-positive gastric fluid (GF) cultures based on the cause and mode of delivery in preterm newborns. Design Retrospective cohort study. Setting A single university hospital in South Korea. Population Women with a singleton pregnancy who delivered prematurely (between 23+0 and 32+0 weeks of gestation, N=464). Methods The newborns’ GF was obtained on the day of birth via nasogastric intubation. The frequency of Ureaplasma-positive GF cultures was compared according to the cause and mode of delivery. Main outcome measures Ureaplasma spp.-positivity in GF cultures. Results Ureaplasma spp. was detected in 20.3% of the GF samples. The presence of Ureaplasma spp. was significantly higher in the spontaneous preterm birth group than in the indicated preterm birth group (30.2% vs 3.0%; P < 0.001). Additionally, Ureaplama spp. was more frequently found in the vaginal delivery group than in the cesarean delivery group, irrespective of the cause of preterm delivery [indicated preterm birth group (22.2% vs. 1.9%, P = 0.023); spontaneous preterm birth group (37.7% vs. 24.2%, P = 0.015)]. Conclusions Ureaplasma spp. were found in 20.3% of the GFs. However, only 1.9% of newborns in the indicated preterm birth group with cesarean delivery had a Ureaplasma-positive GF culture. Our findings support the view that the amniotic cavity is a sterile environment before the onset of parturition. Funding Ministry of Health & Welfare and Ministry of Science and ICT, Republic of Korea (Grant No. HI22C1859) and the Seoul National University Bundang Hospital Research Fund (Grant No. 14-2021-0025).

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Section: Introductionmentioning

confidence: 99%

“…Preterm deliveries fall into two principal categories: spontaneous preterm labor and Iatrogenic preterm birth [ 2 , 12 ]. Existing research posits that spontaneous preterm deliveries may contribute to as much as 50% of all preterm deliveries [ 2 , 12 ]. Nevertheless, despite the frequent presence of multiple risk factors in the spontaneous preterm birth population, such as advanced age, obesity, black race, infections, cervical insufficiency and environmental stress [ 2 , 4 , [13] , [14] , [15] , [16] , [17] ], the intricate mechanisms governing spontaneous preterm birth remain elusive, impeding a comprehensive understanding of its causative factors [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Preterm birth, a consequence of immune deviation mediated hyperinflammation

Wei,

Zhang,

et al. 2024

Heliyon

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Iatrogenic and spontaneous preterm birth in England: A population‐based cohort study

Abstract: Objective: To describe the rates of and risk factors associated with iatrogenic and spontaneous preterm birth and the variation in rates between hospitals.

Cited by 6 publications

References 28 publications

Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study

Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study

Analysis of gastric fluid in preterm newborns supports the view that the amniotic cavity is sterile before the onset of parturition: a retrospective cohort study

Preterm birth, a consequence of immune deviation mediated hyperinflammation

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