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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Akhter, Tansim,1967-Uppsala universitet,Klinisk obstetrik (författare)

Maternal and Perinatal Outcomes in Singleton Nulliparous Spontaneous Preterm Birth with and without Preterm Premature Rupture of Membranes—A National Population-Based Cohort Study

Artikel/kapitelEngelska2022

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2022-12-29
Georg Thieme Verlag KG,2022
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LIBRIS-ID:oai:DiVA.org:uu-499613
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-499613URI
https://doi.org/10.1055/a-1973-7482DOI

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Språk:engelska
Sammanfattning på:engelska

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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.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
Obstetrik och gynekologi
Obstetrics and Gynaecology

Biuppslag (personer, institutioner, konferenser, titlar ...)

Hesselman, Susanne,1973-Uppsala universitet,Klinisk obstetrik,Centrum för klinisk forskning Dalarna(Swepub:uu)sushe649 (författare)
Lindström, Linda,1978-Uppsala universitet,Klinisk obstetrik(Swepub:uu)linli329 (författare)
Axelsson, Ove,1944-Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Obstetrisk och reproduktiv hälsoforskning(Swepub:uu)oveaxels (författare)
Sundström Poromaa, Inger,1964-Uppsala universitet,Reproduktiv hälsa(Swepub:uu)inspo702 (författare)
Uppsala universitetKlinisk obstetrik (creator_code:org_t)

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Ingår i:American Journal of Perinatology: Georg Thieme Verlag KG0735-16311098-8785

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Av författaren/redakt...: Akhter, Tansim, ...; Hesselman, Susan ...; Lindström, Linda ...; Axelsson, Ove, 1 ...; Sundström Poroma ...

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Av lärosätet: Uppsala universitet

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