Preterm Delivery; Who Is at Risk?

Dvora Kluwgant, Tamar Wainstock, Eyal Sheiner, Gali Pariente

Research output: Contribution to journalArticlepeer-review

Abstract

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24-28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14-8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58-9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00-24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

Original languageEnglish
Article number2279
Number of pages12
JournalJournal of Clinical Medicine
Volume10
Issue number11
DOIs
StatePublished - 24 May 2021

Keywords

  • Extreme preterm birth
  • Placental abruption
  • Prematurity
  • Preterm birth

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