Maternal and Perinatal Outcomes in Singleton Nulliparous Spontaneous Preterm Birth with and without Preterm Premature Rupture of Membranes—A National Population-Based Cohort Study
| العنوان: | Maternal and Perinatal Outcomes in Singleton Nulliparous Spontaneous Preterm Birth with and without Preterm Premature Rupture of Membranes—A National Population-Based Cohort Study |
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| المؤلفون: | Tansim Akhter, Susanne Hesselman, Linda Lindström, Ove Axelsson, Inger Sundström Poromaa |
| المصدر: | American Journal of Perinatology. |
| بيانات النشر: | Georg Thieme Verlag KG, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Pediatrics, Perinatology and Child Health, Obstetrics and Gynecology |
| الوصف: | Objective Preterm birth (PTB, birth before 37 gestational weeks) is the leading cause of neonatal death and a major challenge for obstetric and neonatal care. About two-thirds of PTBs are spontaneous PTB (sPTB), of which approximately 30% start with preterm premature rupture of membranes (PPROM). The aim of the study was to investigate risk factors and maternal and perinatal outcomes in sPTB with and without PPROM. Study Design This is a national population-based cohort study including all singleton pregnancies in nulliparous women with spontaneous onset of labor and vaginal births (n = 266,968) registered in the Swedish Medical Birth Register 2005 to 2014. sPTB with PPROM (sPTB-PPROM) and sPTB without PPROM were compared regarding risk factors and maternal and perinatal outcomes. Logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, body mass index, country of birth, smoking, chronic hypertension, pregestational and gestational diabetes, and gestational length. Results sPTB-PPROM (n = 5,037), compared with sPTB without PPROM (n = 8,426), was more common in women with previous spontaneous abortions, prepregnancy urinary tract infections, chronic hypertension, and gestational diabetes and had a higher risk of postpartum endometritis (aOR: 2.78, 95% CI: 1.55–5.00). Infants born to women with sPTB-PPROM had a lower risk of birth asphyxia (aOR: 0.60, 95% CI: 0.43–0.83), respiratory distress syndrome (aOR: 0.86, 95% CI: 0.70–1.00), retinopathy of prematurity (aOR: 0.93, 95% CI: 0.92–0.94), necrotizing enterocolitis (aOR: 0.95, 95% CI: 0.94–0.96), and higher risk of hypoglycemia (aOR: 1.14, 95% CI: 1.01–1.28), and hyperbilirubinemia (aOR: 1.28, 95% CI: 1.19–1.38) compared with infants born to sPTB without PPROM. Conclusion Our findings of risk factors and distinct differences in adverse outcomes after sPTB-PPROM compared with sPTB without PPROM are of vital importance and might serve as a basis when elaborating programs for the prevention and management of PPROM. Key Points |
| تدمد: | 1098-8785 0735-1631 |
| DOI: | 10.1055/a-1973-7482 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fe3afa4e57c915d4ce07d0493fe7255e https://doi.org/10.1055/a-1973-7482 |
| رقم الانضمام: | edsair.doi.dedup.....fe3afa4e57c915d4ce07d0493fe7255e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10988785 07351631 |
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| DOI: | 10.1055/a-1973-7482 |