Document Detail


Do neonatal outcomes differ depending on the cause of preterm birth? A comparison between spontaneous birth and iatrogenic delivery for preeclampsia.
MedLine Citation:
PMID:  19644790     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared short-term neonatal outcomes between premature infants with spontaneous preterm birth (s-PTB) and those delivered due to preeclampsia (PEC). Data were collected from women with singleton pregnancies admitted with spontaneous preterm labor (PTL) (2002 to 2005) and PEC (2005 to 2007). Patients delivering 24 to 36(6/7) weeks were analyzed. The incidence of adverse outcomes was compared. Chi-square and Fisher exact tests compared outcomes between neonates of varying gestational ages, and Poisson regression was used to control for confounders. Data describing 368 infants are included (PTL: n = 224; PEC: n = 144). Overall, s-PTB infants had less favorable outcomes at earlier gestational ages, and at later gestational ages those born preterm secondary to PEC (pec-PTB) had less favorable outcomes. s-PTB infants 24 to 27(6/7) weeks were 21% more likely to stay in the neonatal intensive care unit (NICU) > or = 8 days than pec-PTB infants (incident rate ratios [IRR] 0.79, P = 0.002, 95% confidence interval [CI] 0.68 to 0.92). Pec-PTB infants 32 to 33(6/7) weeks were 6 times more likely to stay in the NICU > or = 31 days than s-PTB infants (IRR 5.82, P = 0.03, 95% CI 1.20 to 28.31). Short-term neonatal outcomes differ by the etiology of preterm birth. These data can help facilitate proper patient counseling and allocation of resources. Future studies should address mechanisms by which the etiology of PTB leads to specific adverse outcomes, thus allowing for more direct interventional strategies.
Authors:
Jamie A Bastek; Sindhu K Srinivas; Mary D Sammel; Michal A Elovitz
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-30
Journal Detail:
Title:  American journal of perinatology     Volume:  27     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-04-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers.
Affiliation:
Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA. jbastek@obgyn.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use
Betamethasone / therapeutic use
Case-Control Studies
Delivery, Obstetric*
Drug Utilization
Female
Fetal Growth Retardation / epidemiology
Gestational Age
Glucocorticoids / therapeutic use
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology*
Intensive Care Units, Neonatal
Length of Stay / statistics & numerical data
Magnesium Sulfate / therapeutic use
Male
Pre-Eclampsia / epidemiology*,  therapy*
Pregnancy
Premature Birth / epidemiology*
Prospective Studies
Respiration, Artificial / utilization
Retrospective Studies
Tocolytic Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Glucocorticoids; 0/Tocolytic Agents; 378-44-9/Betamethasone; 7487-88-9/Magnesium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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