Document Detail


Recurrence of spontaneous versus medically indicated preterm birth.
MedLine Citation:
PMID:  16949395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Despite the increased tendency of preterm birth to recur, little is known with regard to recurrence risks for spontaneous and medically indicated preterm birth as well as recurrence risks in relation to severity of preterm birth. We examined the recurrence of spontaneous and medically indicated preterm birth. STUDY DESIGN: A population-based, retrospective cohort study of births in Missouri (1989 to 1997) was carried out with analyses restricted to women who delivered their first 2 consecutive singleton live births (n = 154,809). Women who experienced spontaneous onset of labor and subsequently delivered preterm (less than 35 weeks) were classified as spontaneous preterm birth. Medically indicated preterm birth included women who delivered preterm through a labor induction or a prelabor cesarean delivery. Risk and odds ratio of preterm birth recurrence were derived from fitting multivariate conditional logistic regression models after adjusting for potential confounders. RESULTS: If the first pregnancy resulted in a spontaneous preterm birth, then affected women were more likely to deliver preterm spontaneously (adjusted odds ratio 3.6, 95% confidence interval 3.2, 4.0) and also as a medically indicated preterm birth (odds ratio 2.5, 95% confidence interval 2.1, 3.0) in the second birth. Similarly, if the first pregnancy resulted in a medically indicated preterm birth, affected women were 10.6-fold (95% confidence interval 10.1, 12.4) more likely to deliver preterm because of medical indications in the second pregnancy as well as preterm spontaneously (odds ratio 1.6, 95% confidence interval 1.3, 2.1). The greatest risk of recurrence of preterm birth in the second pregnancy tended to occur around the same gestational age as preterm birth in the first pregnancy, regardless of the clinical subtype. CONCLUSION: The observation that spontaneous preterm birth is not only associated with increased recurrence of spontaneous but also medically indicated preterm birth and vice versa, suggests that the 2 clinical subtypes may share common etiologies.
Authors:
Cande V Ananth; Darios Getahun; Morgan R Peltier; Hamisu M Salihu; Anthony M Vintzileos
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  195     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-04     Completed Date:  2006-10-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-50     Citation Subset:  AIM; IM    
Affiliation:
Division of Epidemiology and Biostatistics, Univeristy of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-1977, USA. cande.ananth@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Confounding Factors (Epidemiology)
Female
Gestational Age
Humans
Logistic Models
Missouri / epidemiology
Obstetric Labor, Premature / epidemiology*
Odds Ratio
Pregnancy
Premature Birth / epidemiology*
Recurrence
Retrospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
HD-038902/HD/NICHD NIH HHS

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


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