Preterm births in Iceland 1997‐2016: Preterm birth rates by gestational age groups and type of preterm birth

Grétarsdóttir, Áslaug Salka; Aspelund, Thor; Steingrímsdóttir, Þóra; Bjarnadóttir, Ragnheiður I.; Einarsdóttir, Kristjana

doi:10.1111/birt.12467

Cited by 12 publications

(12 citation statements)

References 34 publications

(126 reference statements)

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“…The effect may be exclusive to prelabor cesarean births. We previously reported on the iatrogenic preterm birth rate in Iceland (induction of labor and prelabor cesarean birth), which has also significantly increased since 1997, despite adjustment for clinical indication groups 20 . For the study reported here, we also adjusted the preterm prelabor CB rate for clinical indication groups, which did not affect the results.…”

Section: Discussionmentioning

confidence: 98%

Trends in cesarean birth rates in Iceland over a 19‐year period

Haggar

Einarsdóttir

2020

Birth

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Background Cesarean birth (CB) rates have increased in high‐resource countries during the past two decades, yet it is not known whether CB rates have changed according to maternal age and/or gestational age. Methods All singleton live births in Iceland between 1997 and 2015 were identified from the Icelandic Medical Birth Registry (80 130). Rates of cesarean births (intrapartum and prelabor) were calculated overall and separately for maternal age groups and gestational age groups and by parity. Logit binomial regression was used to calculate odds ratios (ORs) and confidence intervals (CIs) for annual change in cesarean birth rates adjusted for maternal characteristics and clinical indication groups. Results The overall CB rate was 15.7% in 1997 and 15.8% in 2015; the CB rate did not change significantly during the study period. The overall CB rate for early‐term deliveries (37‐38 weeks) decreased for multiparas (annual aOR = 0.99 [95% CI = 0.98‐0.99]), and the preterm (<37 weeks) prelabor cesarean rate increased significantly (1.11 [1.09‐1.14]) for both primiparas and multiparas. For multiparas only, the intrapartum CB rate decreased (0.97 [0.97‐0.98]), whereas the prelabor CB rate increased, predominantly for women aged over 35 years (1.03 [1.02‐1.04]). Adjustment for clinical indication groups did not change these results. Conclusions Findings indicate a rise in prelabor cesarean for preterm births and women aged over 35 years (multiparas only). As adjustment for clinical indications did not affect these results, changes in obstetric practice are more likely to have affected these rate changes rather than changes in clinical indications.

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Section: Discussionmentioning

confidence: 98%

Trends in cesarean birth rates in Iceland over a 19‐year period

Haggar

Einarsdóttir

2020

Birth

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“…Fyrirburafaeðingar eru taldar vera á bilinu 5-18% faeðinga á heimsvísu og þar af eru Norðurlöndin með hvað laegsta tíðni. 13 Meðaltal á heimsvísu er 10,6% 14 en þrátt fyrir að tíðnin hér á landi sé laegri, hafa fyrirburafaeðingar hér á landi aukist úr 4,8% árin 1972-1981 í 6,1% árin 2012-2016. Meirihluti fyrirburafaeðinga fer sjálfkrafa af stað, 15 en tíðni meðferðartengdra fyrirburafaeðinga hefur aukist undanfarin ár vegna sjúkdómsástands móður eða fósturstreitu.…”

Section: Inngangurunclassified

“…Meðferðartengdar fyrirburafaeðingar eru nú um tvöfalt hlutfall af fyrirburafaeðingum á Íslandi miðað við árið 1997, eða 43% af öllum fyrirburafaeðingum. 14 Fylgikvillar fyrirburafaeðinga valda um 35% dauðsfalla hjá nýburum og 16% hjá börnum undir 5 ára aldri. 16 Auk þess kljást fyrirburar við ýmsa kvilla sem eru tengdir því að hafa faeðst fyrir tímann eins og öndunarfaerasjúkdóma, taugakvilla, og sjón-og heyrnarskerðingu.…”

Section: Inngangurunclassified

“…8,10,13 Marga af þessum þáttum er haegt að bera kennsl á og í sumum tilfellum koma í veg fyrir eða meðhöndla með árangursríkri meðgönguvernd. 18 Í nýlegri rannsókn 14 voru helstu ástaeður fyrir meðferðartengdum fyrirburafaeðingum á Íslandi fósturstreita, fylgjulos, sykursýki, gallstasi og veikindi móður. Aðrar algengar ástaeður geta verið meðgöngueitrun og vaxtarskerðing fósturs.…”

Section: áHaettuþaettir Og Fyrirburafaeðingarunclassified

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Preterm birth among Icelandic and migrant women in Iceland during 1997-2018 and main contributing factors

Guðmundsdóttir

Vigfusdottir

Gottfreðsdóttir

2023

LBL

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INTRODUCTION: Migrant women often experience worse perinatal outcomes during pregnancy, birth, and puerperium than native women, but results regarding preterm birth vary. The objective of this study was to detect the prevalence and risk factors of preterm birth among Icelandic and migrant women in Iceland. MATERIAL AND METHODS: The study was a population-based cohort study with data from the Icelandic Medical Birth Register. The cohort included all women who had a singleton birth from 22w0d to 36w6d of pregnancy in the years 1997-2018, a total of 89 170 women. The group was divided in two; women with an Icelandic citizenship and women with foreign citizenship, that were further divided according to the Human Development Index (HDI) of their country of citizenship. Preterm birth rate and risk factor prevalence was analysed according to this classification and significance in differences measured with a chi-square test. RESULTS: Significance in differences of preterm birth was found between Icelandic (4.4%) and migrant women (5.6%) (p<0.001). Migrant women from middle-HDI countries gave birth preterm in 5.5% of cases (p<0.01) and women from low-HDI countries in 6.4% of cases (p<0.001). Migrant women were more often diagnosed with urinary tract infections, diabetes, intrauterine growth restriction and premature rupture of membranes, but less often with pre-eclampsia, obesity, placental defect, mental health issues and age <18 years (p<0.05). CONCLUSION: Migrant women in Iceland from middle-HDI and low-HDI countries give birth preterm more often than Icelandic women. A difference in risk factors is also present and needs further research. The findings can be used in continuing development of prenatal care for migrant women in Iceland.

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“…It occurs in 8%-13% of all pregnancies and is a major cause of perinatal mortality and morbidity. It also brings a considerable economic burden to families and society [ 2 ]. As many as 50% of spontaneous PTBs are linked to inflammatory cascades that induce uterine contractions.…”

Section: Introductionmentioning

confidence: 99%

Metabonomics profile analysis in inflammation-induced preterm birth and the potential role of metabolites in regulating premature cervical ripening

Yan

et al. 2022

Reprod Biol Endocrinol

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Background Preterm birth (PTB) is the primary cause of infant morbidity and mortality. Moreover, previous studies have established that PTB is related to premature cervical ripening. However, the underlying mechanism remains to be elucidated. This study sought to identify differentially expressed metabolites and investigate their potential biological functions in PTB. Methods Pregnant C57BL/6 J mice were treated with either LPS or normal saline and cervical alterations before labor were detected by staining. Metabolic profiles in the plasma of PTB and control mice were examined through non-targeted metabonomics analyses, quantitative polymerase chain reaction and immunofluorescence staining were performed on human cervical smooth cells. Results The study demonstrated that the mRNA and protein levels of α-SMA, SM-22, and calponin in cervical smooth muscle cells of PTB mice were lower while OR was higher at both mRNA and protein levels compared to the CTL group. A total of 181 differentially expressed metabolites were analyzed, among them, 96 were upregulated, while 85 were downregulated in the PTB group. Differentially expressed metabolites may play a role in STAT3, RhoA, mTOR, TGF-β, and NK-κB signaling pathways. Furthermore, when treated with taurine, the levels of α-SMA and SM-22 in human cervical smooth muscle cells were elevated, whereas that of connexin-43 was decreased. Conclusion Our study highlighted the changes of metabolites in the peripheral blood changed prior to PTB and revealed that these differentially expressed metabolites might participate in the development of premature cervical ripening. Taurine was identified as an important metabolite may modulate human cervical smooth muscle cells. Our study provided new insights into the mechanism underlying premature cervical ripening in PTB.

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Preterm births in Iceland 1997‐2016: Preterm birth rates by gestational age groups and type of preterm birth

Cited by 12 publications

References 34 publications

Trends in cesarean birth rates in Iceland over a 19‐year period

Trends in cesarean birth rates in Iceland over a 19‐year period

Preterm birth among Icelandic and migrant women in Iceland during 1997-2018 and main contributing factors

Metabonomics profile analysis in inflammation-induced preterm birth and the potential role of metabolites in regulating premature cervical ripening

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