OBJECTIVE: The objective of the study was to estimate and compare the relative risk of preterm birth (PTB) in pregnancies complicated by 1 or more of 8 major congenital malformations (MCMs). STUDY DESIGN: This was a population-based cohort study of the birth database of the Missouri Department of Health (1989-1997) including 678,693 singleton live births. Outcomes included a binary composite variable of any MCM and the following 8 individual malformations: spina bifida, diaphragmatic hernia, renal agenesis, other urogenital anomaly, tracheoesophageal fistula/esophageal atresia, omphalocele/gastroschisis, cardiac defect, and cleft lip/palate. Chromosomal anomalies were excluded. Logistic regression analyses assessed the association between malformations and PTB. RESULTS: The risk of PTB increased significantly and to varying degrees for each malformation. In pregnancies with any MCM, there was an increased prevalence (11.5%) and relative risk (adjusted odds ratio [(adj)OR] 3.2 [95% confidence interval (CI) 2.9 to 3.6]) of PTB at less than 35 weeks' gestation. The magnitude of risk increase was greatest at the earliest gestational ages: (adj)OR 4.8 (95% CI, 4.0 to 5.7) at less than 28 weeks. Pregnancies with multiple malformations were at highest risk for PTB: (adj)OR 8.0 [95% CI, 4.6 to 14.1]. CONCLUSION: MCMs significantly increase PTB risk. The risk varies by malformation type and is higher with multiple malformations.
OBJECTIVE: The objective of the study was to estimate and compare the relative risk of preterm birth (PTB) in pregnancies complicated by 1 or more of 8 major congenital malformations (MCMs). STUDY DESIGN: This was a population-based cohort study of the birth database of the Missouri Department of Health (1989-1997) including 678,693 singleton live births. Outcomes included a binary composite variable of any MCM and the following 8 individual malformations: spina bifida, diaphragmatic hernia, renal agenesis, other urogenital anomaly, tracheoesophageal fistula/esophageal atresia, omphalocele/gastroschisis, cardiac defect, and cleft lip/palate. Chromosomal anomalies were excluded. Logistic regression analyses assessed the association between malformations and PTB. RESULTS: The risk of PTB increased significantly and to varying degrees for each malformation. In pregnancies with any MCM, there was an increased prevalence (11.5%) and relative risk (adjusted odds ratio [(adj)OR] 3.2 [95% confidence interval (CI) 2.9 to 3.6]) of PTB at less than 35 weeks' gestation. The magnitude of risk increase was greatest at the earliest gestational ages: (adj)OR 4.8 (95% CI, 4.0 to 5.7) at less than 28 weeks. Pregnancies with multiple malformations were at highest risk for PTB: (adj)OR 8.0 [95% CI, 4.6 to 14.1]. CONCLUSION: MCMs significantly increase PTB risk. The risk varies by malformation type and is higher with multiple malformations.
Authors: Heather H Burris; Sheryl L Rifas-Shiman; Andrea Baccarelli; Letizia Tarantini; Caroline E Boeke; Ken Kleinman; Augusto A Litonjua; Janet W Rich-Edwards; Matthew W Gillman Journal: J Dev Orig Health Dis Date: 2012-06 Impact factor: 2.401
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Authors: Elizabeth Radcliff; Cynthia H Cassell; Jean Paul Tanner; Russell S Kirby; Sharon Watkins; Jane Correia; Cora Peterson; Scott D Grosse Journal: Birth Defects Res A Clin Mol Teratol Date: 2012-11-01
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Authors: R M Phillips; M Goldstein; K Hougland; R Nandyal; A Pizzica; A Santa-Donato; S Staebler; A R Stark; T M Treiger; E Yost Journal: J Perinatol Date: 2013-07 Impact factor: 2.521
Authors: David M Howard; Oliver Pain; Ryan Arathimos; Miruna C Barbu; Carmen Amador; Rosie M Walker; Bradley Jermy; Mark J Adams; Ian J Deary; David Porteous; Archie Campbell; Patrick F Sullivan; Kathryn L Evans; Louise Arseneault; Naomi R Wray; Michael Meaney; Andrew M McIntosh; Cathryn M Lewis Journal: Hum Mol Genet Date: 2022-02-21 Impact factor: 6.150