Epidemiology and Related Risk Factors of Preterm Labor as an Obstetrics Emergency
Vol. 5 No. 1 (2017),
Introduction: Preterm birth is still a major health problem throughout the world, which results in 75% of neonatal mortality. Preterm labor not only inflicts financial and emotional distress, it may also lead to permanent disability. The present study was conducted to determine the related risk factors and preventive measures of preterm labor.
Methods: This retrospective cross-sectional study assessed all preterm labors, as well as an equal number of term labors, during seven years, at an educational hospital. Probable risk factors of preterm labor were collected using medical profiles of participants by the aid of a pre-designed checklist. Significant related factors of preterm labor were used for multivariate logistic regression analysis with SPSS 21.0.
Result: 810 cases with the mean age of 28.33 ± 6.1 years were evaluated (48.7% preterm). Multipartite; fetal anomaly; prenatal care; smoking; not consuming folic acid and iron supplements; in vitro fertilization; history of infertility, caesarian section, trauma, systemic disease, and hypertension; amniotic fluid leak; rupture of membranes; cephalic presentation; vaginal bleeding; placenta decolman; oligohydramnios; pre-eclampsia; chorioamnionitis; uterine abnormalities; cervical insufficiency; intercourse during the previous week; short time since last delivery; and mother’s weight significantly correlated with preterm labor.Conclusion: Based on the results of the present study, intercourse during the previous week, multipartite, short time from last delivery, preeclampsia, fetal anomaly, rupture of membranes, hypertension, and amniotic fluid leak, respectively, were risk factors for preterm labor. On the other hand, iron consumption, cephalic presentation, systematic disease, history of caesarian section, prenatal care, and mother’s weight could be considered as protective factors.
- Premature birth
- obstetric labor
- fetal membranes
- premature rupture
Kliegman RM, Behrman R, Jenson H. Stanton B. Nelson textbook of pediatrics. Germany: Elsevier Health Sciences; 2007.
Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D. Spong CY Williams Obstetrics. USA: The McGraw-Hill Companies, Inc. Medical Publishing Division; 2010.
Lawn JE, Cousens S, Zupan J, Team LNSS. 4 million neonatal deaths: when? Where? Why? The Lancet. 2005;365(9462):891-900.
Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. The Lancet. 2008;371(9608):261-9.
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012;379(9832):2162-72.
Langhoff-Roos J, Kesmodel U, Jacobsson B, Rasmussen S, Vogel I. Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study. Bmj. 2006;332(7547):937-9.
Norman JE, Morris C, Chalmers J. The effect of changing patterns of obstetric care in Scotland (1980-2004) on rates of preterm birth and its neonatal consequences: perinatal database study. PLoS medicine. 2009;6(9):1009.
Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS Med. 2011;8(8):e1001080.
Organization WH. Born too soon: the global action report on preterm birth. 2012.
Zeitlin J, Szamotulska K, Drewniak N, Mohangoo A, Chalmers J, Sakkeus L, et al. Preterm birth time trends in Europe: a study of 19 countries. BJOG: An International Journal of Obstetrics & Gynaecology. 2013;120(11):1356-65.
Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Wilson EC, Mathews T. Births: final data for 2010. National vital statistics reports. 2012;61(1):1-72.
Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization. 2010;88(1):31-8.
Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC pregnancy and childbirth. 2010;10(Suppl 1):S1.
Afrakhteh M, Ebrahimi S, VALAEI N. PREVALENCE OF PRETERM DELIVERY AND ITS RELATED FACTORS IN FEMALES REFERRING TO SHOHADA TAJRISH HOSPITAL, 1995-99. 2002.
Pourarian S, Vafafar A, Zareh Z. The incidence of prematurity in the Hospital of Shiraz university of medical sciences and health services, 1999. Razi Journal of Medical Sciences. 2002;9(28):19-25.
MOHSENZADEH A, SAKET S, KARIMI A. Prevalence of preterm neonates and risk factors. 2011.
Gomella T. Polycythemia and hyperviscocity. Dalam: Gomella TL, Cunningham MD, Eyal FG, Zenk KE, penyunting. Neonatology: management, procedures, on call problems, diseases and drugs. Edisi ke-5. NewYork: McGraw–Hill; 2004.
Meis PJ, Goldenberg RL, Mercer BM, Iams JD, Moawad AH, Miodovnik M, et al. The preterm prediction study: risk factors for indicated preterm births. American journal of obstetrics and gynecology. 1998;178(3):562-7.
Burke C, Morrison JJ. Perinatal factors and preterm delivery in an Irish obstetric population. Journal of perinatal medicine. 2000;28(1):49-53.
McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. New England journal of medicine. 1985;312(2):82-90.
Romero R, Espinoza J, Kusanovic JP, Gotsch F, Hassan S, Erez O, et al. The preterm parturition syndrome. BJOG: An International Journal of Obstetrics & Gynaecology. 2006;113(s3):17-42.
Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2005. National vital statistics reports. 2006;55(11):1-18.
Goldenberg RL, Rouse DJ. Prevention of premature birth. New England Journal of Medicine. 1998;339(5):313-20.
Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization. 1987;65(5):663.
HEDIGER ML, SCHOLL TO, BELSKY DH, ANCES IG, SALMON RW. Patterns of weight gain in adolescent pregnancy: effects on birth weight and preterm delivery. Obstetrics & Gynecology. 1989;74(1):6-12.
Carmichael S, Abrams B, Selvin S. The pattern of maternal weight gain in women with good pregnancy outcomes. American Journal of Public Health. 1997;87(12):1984-8.
Ebrahimi S, Haghbin S, PoorMahmoodi A. Incidence and etiologic factors of prematurity. 2000.
Heaman M, Kingston D, Chalmers B, Sauve R, Lee L, Young D. Risk Factors for Preterm Birth and Small‐for‐gestational‐age Births among Canadian Women. Paediatric and perinatal epidemiology. 2013;27(1):54-61.
Care P. Medicaid Recipients and Uninsured Women Obtain Insufficient Care. Government Accounting Office (GAO), Washington DC. 1987.
Sokol RJ, Woolf RB, Rosen MG, Weingarden K. Risk, antepartum care, and outcome: impact of a maternity and infant care project. Obstetrics & Gynecology. 1980;56(2):150-6.
Meis PJ, Goldenberg RL, Mercer B, Moawad A, Das A, McNellis D, et al. The preterm prediction study: significance of vaginal infections. American journal of obstetrics and gynecology. 1995;173(4):1231-5.
Paige DM, Augustyn M, Adih WK, Witter F, Chang J. Bacterial vaginosis and preterm birth: a comprehensive review of the literature. Journal of Nurse-Midwifery. 1998;43(2):83-9.
Romero R, Mazor M. Infection and preterm labor. Clinical obstetrics and gynecology. 1988;31(3):553-84.
Holst E, Goffeng AR, Andersch B. Bacterial vaginosis and vaginal microorganisms in idiopathic premature labor and association with pregnancy outcome. Journal of clinical microbiology. 1994;32(1):176-86.
Keirse M. An evaluation of formal risk scoring for preterm birth. American journal of perinatology. 1989;6(2):226-33.
Shiono PH, Klebanoff MA, Rhoads GG. Smoking and drinking during pregnancy: their effects on preterm birth. Jama. 1986;255(1):82-4.
Klebanoff MA, Graubard BI, Kessel SS, Berendes HW. Low birth weight across generations. Jama. 1984;252(17):2423-7.
Spohr H-L, Willms J, Steinhausen H-C. Prenatal alcohol exposure and long-term developmental consequences. The Lancet. 1993;341(8850):907-10.
Vahratian A, Siega-Riz AM, Savitz DA, Thorp JM. Multivitamin use and the risk of preterm birth. American journal of epidemiology. 2004;160(9):886-92.
Czeizel A, Dudas I, Metneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Archives of gynecology and obstetrics. 1994;255(3):131-9.
Obstetricians ACo, Gynecologists. The importance of preconception care in the continuum of women’s healthcare. Committee Opinion No. 313. Obstet Gynecol. 2005;106(3):665-6.
Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth (Review). Cochrane Database Syst Rev. 2006;19:CD004454.
Wapner RJ, Sorokin Y, Thom EA, Johnson F, Dudley DJ, Spong CY, et al. Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy. American journal of obstetrics and gynecology. 2006;195(3):633-42.
McClamrock HD, Jones HW, Adashi EY. Ovarian stimulation and intrauterine insemination at the quarter centennial: implications for the multiple births epidemic. Fertility and sterility. 2012;97(4):802-9.
Ferraretti A, Goossens V, De Mouzon J, Bhattacharya S, Castilla J, Korsak V, et al. Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Human reproduction. 2012;27(9):2571-84.
- Abstract Viewed: 1892 times
- PDF Downloaded: 1043 times