Download PDF
Am J Perinatol 2015; 32(14): 1305-1310
DOI: 10.1055/s-0035-1563716
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fetal Gender of the First Born and the Recurrent Risk of Spontaneous Preterm Birth

Esmé I. Kamphuis
1   Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
3   Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands
,
Bouchra Koullali
1   Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
,
Michel Hof
2   Department of Clinical Epidemiology, Bioinformatics, and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands
,
Christianne J. M. de Groot
3   Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands
,
Brenda M. Kazemier
1   Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
,
Sarah Robertson
4   The Robinson Research Institute | School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia
,
Ben W. J. Mol
4   The Robinson Research Institute | School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia
,
Anita C. Ravelli
1   Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
5   Department of Medical Informatics, Academic Medical Centre, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

09 July 2015

21 July 2015

Publication Date:
09 September 2015 (online)

Also available at
    Permissions and Reprints

Abstract

Objective To study, in women with a spontaneous preterm birth (sPTB) in the first pregnancy, the effect of fetal sex in that first pregnancy on the recurrent sPTB risk.

Study Design A nationwide retrospective cohort study (data from National Perinatal Registry) on all women with two sequential singleton pregnancies (1999–2009) with the first delivery ending in sPTB <37 weeks. We used logistic regression analysis to study the association between fetal gender in the first pregnancy and the risk of recurrent sPTB. We repeated the analysis for sPTB < 32 weeks.

Results The overall incidence of sPTB <37 weeks in the first pregnancy was 4.5% (15,351/343,853). Among those 15,351 women, the risk of recurrent sPTB <37 weeks was increased when the first fetus was female compared when that fetus was male (15.8 vs. 15.2%; adjusted odds ratio [aOR] 1.2; 95% confidence interval [CI] 1.05–1.3). A similar effect was seen for sPTB <32weeks (8.2 vs. 5.9%; aOR 4.5; 95% CI 1.5–13).

Conclusion Women who suffer sPTB of a female fetus have an increased risk of recurrent sPTB compared with women who suffer sPTB of a male fetus. This information provides proof for the hypothesis that sPTB is due to an independent maternal and fetal factor.

Keywords

fetal gender - recurrent spontaneous preterm birth

Note

This study was presented as poster at the 2015 Annual Meeting, SMFM, San Diego, CA, February 2–7, 2015.


 

  • References

  • 1 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371 (9606) 75-84
    CrossrefPubMedGoogle Scholar
  • 2 Burkman RT. Clinical obstetrics: the fetus and mother. JAMA 2007; 298 (2) 229-230
    PubMedGoogle Scholar
  • 3 Crump C, Sundquist K, Sundquist J, Winkleby MA. Gestational age at birth and mortality in young adulthood. JAMA 2011; 306 (11) 1233-1240
    CrossrefPubMedGoogle Scholar
  • 4 Crump C, Sundquist K, Winkleby MA, Sundquist J. Early-term birth (37-38 weeks) and mortality in young adulthood. Epidemiology 2013; 24 (2) 270-276
    CrossrefPubMedGoogle Scholar
  • 5 Zeitlin J, Szamotulska K, Drewniak N , et al; Euro-Peristat Preterm Study Group. Preterm birth time trends in Europe: a study of 19 countries. BJOG 2013; 120 (11) 1356-1365
    CrossrefPubMedGoogle Scholar
  • 6 Chang HH, Larson J, Blencowe H , et al; Born Too Soon preterm prevention analysis group. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Lancet 2013; 381 (9862) 223-234
    CrossrefPubMedGoogle Scholar
  • 7 Blencowe H, Cousens S, Oestergaard MZ , et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379 (9832) 2162-2172
    CrossrefPubMedGoogle Scholar
  • 8 National Vital Statistics System, US Department of Health and Human Services, Centers for Disease, Control and Prevention, National Center for Health Statistics. http://205.207.175.93/Vitalstats/ExtractViewer/extractView.aspx?ReportId=70836 . Accessed July 6, 2015.
    PubMedGoogle Scholar
  • 9 Christiaens I, Zaragoza DB, Guilbert L, Robertson SA, Mitchell BF, Olson DM. Inflammatory processes in preterm and term parturition. J Reprod Immunol 2008; 79 (1) 50-57
    CrossrefPubMedGoogle Scholar
  • 10 Adams MM, Elam-Evans LD, Wilson HG, Gilbertz DA. Rates of and factors associated with recurrence of preterm delivery. JAMA 2000; 283 (12) 1591-1596
    CrossrefPubMedGoogle Scholar
  • 11 Simonsen SE, Lyon JL, Stanford JB, Porucznik CA, Esplin MS, Varner MW. Risk factors for recurrent preterm birth in multiparous Utah women: a historical cohort study. BJOG 2013; 120 (7) 863-872
    CrossrefPubMedGoogle Scholar
  • 12 Mazaki-Tovi S, Romero R, Kusanovic JP , et al. Recurrent preterm birth. Semin Perinatol 2007; 31 (3) 142-158
    CrossrefPubMedGoogle Scholar
  • 13 Esplin MS, O'Brien E, Fraser A , et al. Estimating recurrence of spontaneous preterm delivery. Obstet Gynecol 2008; 112 (3) 516-523
    CrossrefPubMedGoogle Scholar
  • 14 Kazemier BM, Buijs PE, Mignini L, Limpens J, de Groot CJ, Mol BW ; EBM CONNECT. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review. BJOG 2014; 121 (10) 1197-1208 , discussion 1209
    CrossrefPubMedGoogle Scholar
  • 15 Zeitlin J, Ancel PY, Larroque B, Kaminski M ; EPIPAGE Study. Fetal sex and indicated very preterm birth: results of the EPIPAGE study. Am J Obstet Gynecol 2004; 190 (5) 1322-1325
    CrossrefPubMedGoogle Scholar
  • 16 Méray N, Reitsma JB, Ravelli AC, Bonsel GJ. Probabilistic record linkage is a valid and transparent tool to combine databases without a patient identification number. J Clin Epidemiol 2007; 60 (9) 883-891
    PubMedGoogle Scholar
  • 17 Schaaf JM, Hof MH, Mol BW, Abu-Hanna A, Ravelli AC. Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery. Am J Obstet Gynecol 2012; 207 (4) 279.e1-279.e7
    CrossrefPubMedGoogle Scholar
  • 18 Schaaf JM, Hof MH, Mol BW, Abu-Hanna A, Ravelli AC. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery. BJOG 2012; 119 (13) 1624-1629
    CrossrefPubMedGoogle Scholar
  • 19 Schober L, Radnai D, Schmitt E, Mahnke K, Sohn C, Steinborn A. Term and preterm labor: decreased suppressive activity and changes in composition of the regulatory T-cell pool. Immunol Cell Biol 2012; 90 (10) 935-944
    CrossrefPubMedGoogle Scholar
  • 20 Guerin LR, Prins JR, Robertson SA. Regulatory T-cells and immune tolerance in pregnancy: a new target for infertility treatment?. Hum Reprod Update 2009; 15 (5) 517-535
    CrossrefPubMedGoogle Scholar
  • 21 Rowe JH, Ertelt JM, Xin L, Way SS. Pregnancy imprints regulatory memory that sustains anergy to fetal antigen. Nature 2012; 490 (7418) 102-106
    CrossrefPubMedGoogle Scholar