Risk Factors of Preterm Delivery in Chonburi Hospital
Abstract
Objective: To determine the transvaginal cervical length and risk factors in the second trimester of pregnancy among preterm delivery.
Material and Methods: This is a retrospective cohort at Chonburi hospital. Inclusion criteria were singleton pregnant women who received antenatal care since 1 Mar 2017, because routine transvaginal cervical length (TVCL) was implemented in singleton pregnancies that underwent transvaginal ultrasound between 16-24 weeks of gestational age. Data such as age, parity, body mass index (BMI), blood pressure, history of preterm birth, smoking behavior, alcohol drinking, gestational diabetes, pregnancy-induced hypertension, serology laboratory test, pap smear result, TVCL, and gestational age at delivery were collected. Data was expressed as mean and median risk factors were analyzed using logistic regression analyses calculated with a 95% confidence interval and a 5% significance level.
Results: A total of 1,010 singleton pregnant women participated in the study, of which, 132 pregnancies developed into preterm deliveries and 878 term deliveries. History of preterm birth, maternal syphilis infection, and pregnancy-induced hypertension were statistically significant risk factors for preterm delivery (OR 12.1, 95% CI 5.6-26.5, OR 3.1, 95% CI 1.1-8.4, and OR 2.4, 95% CI 1.5-4.1, respectively). TVCL and gestational diabetes increased risk in the preterm group but there were no statistically significant differences between the two groups. An additional study found that a short cervical length significantly increased preterm births in the high-risk group.
Conclusion: History of preterm birth, maternal syphilis infection, and pregnancy-induced hypertension were significant risk factors for preterm delivery.
References
Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization. 2010;88:31-8.
Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet. 2016;388(10063):3027-35.
Waitzman NJ, Jalali A, Grosse SD, editors. Preterm birth lifetime costs in the United States in 2016: an update. Elsevier: Seminars in Perinatology; 2021.
Vogel JP, Oladapo OT, Manu A, Gülmezoglu AM, Bahl R. New WHO recommendations to improve the outcomes of preterm birth. The Lancet Global Health. 2015;3(10):589-90.
Iams JD, Paraskos J, Landon MB, Teteris JN, Johnson FF. Cervical sonography in preterm labor. Obstetrics and gynecology. 1994;84(1):40-6.
Esplin MS, Elovitz MA, Iams JD, Parker CB, Wapner RJ, Grobman WA, et al. Predictive accuracy of serial transvaginal cervical lengths and quantitative vaginal fetal fibronectin levels for spontaneous preterm birth among nulliparous women. Jama. 2017;317(10):1047-56.
da Fonseca EB, Damião R, Moreira DA. Preterm birth prevention. Best Practice & Research Clinical Obstetrics & Gynaecology. 2020;69:40-9.
Obstetricians ACo, Gynecologists. Prediction and prevention of spontaneous preterm birth: ACOG Practice Bulletin, Number 234. Obstetrics and gynecology. 2021;138(2):65-90.
McIntosh J, Feltovich H, Berghella V, Manuck T, Medicine SfM-F. The role of routine cervical length screening in selected high-and low-risk women for preterm birth prevention. American journal of obstetrics and gynecology. 2016;215(3):B2-7.
Crane J, Hutchens D. Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008;31(5):579-87.
Flood K, Malone FD, editors. Prevention of preterm birth. Seminars in Fetal and Neonatal Medicine. Elsevier; 2012.
Gulersen M, Bornstein E, Domney A, Blitz MJ, Rafael TJ, Li X, et al. Cerclage in singleton gestations with an extremely short cervix (≤ 10 mm) and no history of spontaneous preterm birth. American Journal of Obstetrics & Gynecology MFM. 2021;3(5):100430.
To M, Skentou C, Chan C, Zagaliki A, Nicolaides K. Cervical assessment at the routine 23‐week scan: standardizing techniques. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2001;17(3):217-9.
Ahumada-Barrios ME, Alvarado GF. Risk Factors for premature birth in a hospital. Revista latino-americana de enfermagem. 2016;24.
Kinpoon K, Chaiyarach S. The incidence and risk factors for preterm delivery in northeast Thailand. Thai Journal of Obstetrics and Gynaecology. 2021:100-11.
Grimes-Dennis J, Berghella V. Cervical length and prediction of preterm delivery. Current Opinion in obstetrics and gynecology. 2007;19(2):191-5.
Dekker GA, Lee SY, North RA, McCowan LM, Simpson NA, Roberts CT. Risk factors for preterm birth in an international prospective cohort of nulliparous women. PloS one. 2012;7(7):39154.
Nalini IA, Nikunj KM, Hariom MS. Evaluation of risk factors for preterm delivery and creasy's risk scoring. International Journal of Medical Research & Health Sciences. 2015;4(2):269-73.
Saluckpetch S, Puntachai P. Association between Anemia in Pregnancy and Preterm Birth at Sunpasitthiprasong Hospital. Thai Journal of Obstetrics and Gynaecology. 2020:142-51.
Buathum N, Punpuckdeekoon P, Imsom-somboon N. The Reliability of Transabdominal Cervical Length Measurement Compared with Transvaginal Measurement at 16-24 Weeks of Gestation. Thai Journal of Obstetrics and Gynaecology. 2019:165-73.
Stein W, Hellmeyer L, Schmidt S, Tekesin I. Intraobserver and interobserver reliability of transvaginal cervical length measurements and quantitative ultrasound tissue characterization of the cervix in the second and third trimester of pregnancy. Ultraschall in der Medizin-European Journal of Ultrasound. 2011;32 Suppl 2:E169-74.
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