Document Detail

Temporal trends of preterm birth subtypes and neonatal outcomes.
MedLine Citation:
PMID:  16648408     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe temporal trends of preterm birth subtypes, neonatal morbidity, and hospital neonatal mortality. METHODS: A database of 1.7 million births that occurred in 51 maternity hospitals in Latin America from 1985 to 2003 was studied. Subgroups of preterm births were classified according to the presence or absence of maternal medical or obstetric complications, spontaneous labor, preterm labor after premature rupture of membranes, induction of labor, or elective cesarean. Outcomes studied, for different periods, were prevalence of small for gestational age, neonatal morbidity, and neonatal mortality. RESULTS: Spontaneous preterm labor without maternal complications was the most frequent subtype of preterm birth (60%), followed by premature rupture of membranes without maternal complications. Preterm births due to elective induction and delivery by elective cesarean increased markedly in the last 20 years, from 10% in 1985-1990 to 18.5% in recent years. Neonates born after spontaneous labor without maternal complications had the lowest mortality rate, but their large numbers made them responsible for one half of the preterm mortality. The induction followed by elective cesarean subgroups accounted for 13.4% of the preterm deaths between 1985 and 1990 and increased to 21.2% between 1996 and 2003. CONCLUSION: Spontaneous labor in mothers without maternal complications is the most frequent cause of preterm births and is also the most important subgroup related to neonatal mortality. However, preterm births due to induction of labor or elective cesarean are increasing in Latin America and are becoming important contributors to neonatal mortality.
Fernando C Barros; Maria del Pilar Vélez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  107     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-01     Completed Date:  2006-06-13     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1035-41     Citation Subset:  AIM; IM    
Pan American Health Organization/World Health Organization Latin American Center for Perinatology and Human Development, Montevideo, Uruguay.
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MeSH Terms
Cesarean Section
Educational Status
Infant Mortality / trends
Infant, Newborn
Infant, Newborn, Diseases / epidemiology*
Infant, Premature
Infant, Small for Gestational Age
Labor, Induced
Latin America
Morbidity / trends
Pregnancy Complications / epidemiology
Premature Birth / epidemiology*

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