The Effect of Prior Term Birth on Risk of Recurrent Spontaneous Preterm Birth

Stephanie E. Purisch; Amy L. Turitz; Michal A. Elovitz; Lisa D. Levine

doi:10.1055/s-0037-1607317

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2018; 35(04): 380-384
DOI: 10.1055/s-0037-1607317

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Prior Term Birth on Risk of Recurrent Spontaneous Preterm Birth

Stephanie E. Purisch

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York

,

Amy L. Turitz

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York

,

Michal A. Elovitz

²Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

,

Lisa D. Levine

²Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

› Institutsangaben

Abstract

Objective The objective of this study was to evaluate the effect of prior term birth on recurrent spontaneous preterm birth (sPTB) risk.

Study Design Retrospective cohort study of 211 women with prior sPTB, comparing women with and without prior term births. The primary outcome was recurrent sPTB <37 weeks. Analyses stratified by gestational age of prior sPTB and adjusted for confounders using multivariable logistic regression.

Results The overall sPTB rate was 33.7%, with no statistical difference between women with and without prior term births (28.9 vs. 37.7%, p = 0.2). Among women with prior second-trimester loss (16–23^6/7 weeks), those with a term birth had a decreased sPTB rate (15.4 vs. 43.2%, p = 0.02), which persisted after adjusting for age and 17-α hydroxyprogesterone caproate use. For women with prior sPTB ≥24 weeks, there was no difference in sPTB with and without prior term births (29.5 vs. 26.6%, p = 0.7). A term birth as the most recent delivery lowered, but did not eliminate, the sPTB risk (19.1 vs. 36.4%, p = 0.1).

Conclusion Prior term birth lowers the risk of recurrent sPTB for women with prior second-trimester loss, but not for women with prior sPTB ≥24 weeks. Women with prior preterm and term births should be counseled accordingly and all sPTB prevention strategies should be recommended.

Keywords

birth order - prematurity - recurrent preterm birth - spontaneous preterm birth

Volltext

Referenzen

References
1 MacDorman MF, Declercq E, Zhang J. Obstetrical intervention and the singleton preterm birth rate in the United States from 1991-2006. Am J Public Health 2010; 100 (11) 2241-2247
2 Goldenberg RL, Iams JD, Mercer BM. , et al; NICHD MFMU Network. The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. Am J Public Health 1998; 88 (02) 233-238
3 Hamilton BE, Martin JA, Osterman MJK, Driscoll AK, Roseen LM. Births: Provisional Data for 2016. Vital Statistics Rapid Release; No 2. Hyattsville, MD: National Center for Health Statistics; 2017
4 Edlow AG, Srinivas SK, Elovitz MA. Second-trimester loss and subsequent pregnancy outcomes: what is the real risk?. Am J Obstet Gynecol 2007; 197 (06) 581.e1-581.e6
5 McManemy J, Cooke E, Amon E, Leet T. Recurrence risk for preterm delivery. Am J Obstet Gynecol 2007; 196 (06) 576.e1-576.e6
6 Iams JD, Goldenberg RL, Mercer BM. , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. The Preterm Prediction Study: recurrence risk of spontaneous preterm birth. Am J Obstet Gynecol 1998; 178 (05) 1035-1040
7 Goldenberg RL, Mayberry SK, Copper RL, Dubard MB, Hauth JC. Pregnancy outcome following a second-trimester loss. Obstet Gynecol 1993; 81 (03) 444-446
8 Levine LD, Bogner HR, Hirshberg A, Elovitz MA, Sammel MD, Srinivas SK. Term induction of labor and subsequent preterm birth. Am J Obstet Gynecol 2014; 210 (04) 354.e1-354.e8
9 Turitz AL, Bastek JA, Purisch SE, Elovitz MA, Levine LD. Patient characteristics associated with 17-alpha hydroxyprogesterone caproate use among a high-risk cohort. Am J Obstet Gynecol 2016; 214 (04) 536.e1-536.e5
10 Meis PJ, Klebanoff M, Thom E. , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med 2003; 348 (24) 2379-2385
11 Owen J, Hankins G, Iams JD. , et al. Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length. Am J Obstet Gynecol 2009; 201 (04) 375.e1-375.e8
12 Method for Estimating Due Date. Committee opinion no 611: method for estimating due date. Obstet Gynecol 2014; 124 (04) 863-866
13 Iams JD. Clinical practice. Prevention of preterm parturition. N Engl J Med 2014; 370 (03) 254-261