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Term complications and subsequent risk of preterm birth: registry based study
- Source :
- BMJ. British Medical Journal, m1007, British Medical Journal (BMJ), The BMJ
- Publication Year :
- 2020
-
Abstract
- ObjectiveTo explore conditions and outcomes of a first delivery at term that might predict later preterm birth.DesignPopulation based, prospective register based study.SettingMedical Birth Registry of Norway, 1999-2015.Participants302 192 women giving birth (live or stillbirth) to a second singleton child between 1999 and 2015.Main outcome measuresMain outcome was the relative risk of preterm delivery (ResultsWomen with any of the five complications at term showed a substantially increased risk of preterm delivery in the next pregnancy. The absolute risks for preterm delivery in a second pregnancy were 3.1% with none of the five term complications (8202/265 043), 6.1% after term pre-eclampsia (688/11 225), 7.3% after term placental abruption (41/562), 13.1% after term stillbirth (72/551), 10.0% after term neonatal death (22/219), and 6.7% after term small for gestational age (463/6939). The unadjusted relative risk for preterm birth after term pre-eclampsia was 2.0 (95% confidence interval 1.8 to 2.1), after term placental abruption was 2.3 (1.7 to 3.1), after term stillbirth was 4.2 (3.4 to 5.2), after term neonatal death was 3.2 (2.2 to 4.8), and after term small for gestational age was 2.2 (2.0 to 2.4). On average, the risk of preterm birth was increased 2.0-fold (1.9-fold to 2.1-fold) with one term complication in the first pregnancy, and 3.5-fold (2.9-fold to 4.2-fold) with two or more complications. The associations persisted after excluding recurrence of the specific complication in the second pregnancy. These links between term complications and preterm delivery were also seen in the reverse direction: preterm birth in the first pregnancy predicted complications in second pregnancies delivered at term.ConclusionsPre-eclampsia, placental abruption, stillbirth, neonatal death, or small for gestational age experienced in a first term pregnancy are associated with a substantially increased risk of subsequent preterm delivery. Term complications seem to share important underlying causes with preterm delivery that persist from pregnancy to pregnancy, perhaps related to a mother’s predisposition to disorders of placental function.
- Subjects :
- Adult
medicine.medical_specialty
Term Birth
Perinatal Death
Young Adult
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Pregnancy
Risk Factors
medicine
Humans
Prospective Studies
Registries
030212 general & internal medicine
Young adult
Prospective cohort study
Abruptio Placentae
030219 obstetrics & reproductive medicine
Placental abruption
Norway
Obstetrics
business.industry
Research
Infant, Newborn
General Medicine
Stillbirth
medicine.disease
3. Good health
Term (time)
Relative risk
Infant, Small for Gestational Age
Premature Birth
Small for gestational age
Female
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- BMJ. British Medical Journal, m1007, British Medical Journal (BMJ), The BMJ
- Accession number :
- edsair.doi.dedup.....979bde132ebc6934a9bfbe1a54faf277