Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

Abstract

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

Effects of Interaction Between Gestational Hypertension and History of Preterm Birth on the Risk of Preterm Birth: An Analysis Based on the National Vital Statistics System Database

“…Furthermore, several studies also revealed HPB was the major risk factor for preterm birth in a current pregnancy [ 10 , 14 , 22 , 23 ], which was consistent with our results that HPB was significantly positively associated with preterm birth in the adjusted model. A study conducted in Kenya of preterm infants showed that HPB was associated with premature birth [ 22 ].…”

“…A study conducted in Kenya of preterm infants showed that HPB was associated with premature birth [ 22 ]. A 12-month retrospective population-based study conducted using registry data from the PEARL-Peristat Study examined 15 865 singleton live births, and HPB (OR: 7.23, 95% CI: 4.44–11.77) was identified as an independent predictor in univariate and multivariate analyses ( P <0.001) [ 14 ]. In a secondary analysis study of data for 2149 women, a history of previous preterm birth independently and significantly increased the odds of preterm birth overall (OR: 2.13, 95% CI: 1.19–3.80) [ 23 ].…”

“…In addition, special attention and intervention for women with HPB are also beneficial [ 12 , 13 ]. Studies have found that GH and HPB have been identified to be risk factors for preterm birth [ 14 , 15 ]. However, the effect of their interaction on preterm birth has not been widely reported.…”

The Influence of Maternal Factors on Neonatal Intensive Care Unit Admission and In-Hospital Mortality in Premature Newborns from Western Romania: A Population-Based Study

“…Identifying risk factors is the first and most critical step in developing intervention methods aimed at reducing the frequency of preterm births and their associated complications. Some known risk factors are maternal age over 35 years, a family history of preterm births, and membrane rupture [23,24]. Understanding these characteristics and their interplay may result in significant advances in preterm birth diagnosis, prevention, and therapy.…”

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“…In its initial phase, the PEARL study was conducted from 2011 to 2013, while this phase covered the 2017-2019 period [76]. This registry reports data on maternal, neonatal and perinatal mortality, morbidities, and their correlates, including data on live births and neonatal mortality from all public and private maternity facilities in Qatar [76,77]. This database is large enough with a sample size that is generally representative of births in Qatar.…”