Ronit Ratzon1, Eyal Sheiner, Ilana Shoham-Vardi. 1. Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Abstract
OBJECTIVE: To assess the independent role of prenatal care in preventing recurrent preterm delivery (<37 weeks gestation) and in reducing adverse pregnancy outcomes in recurrent preterm delivery. STUDY DESIGN: A population-based retrospective cohort study. Participants were 1470 Bedouin women in Southern Israel who at their first delivery (parity 1) gave birth preterm (<37 weeks) and had a consecutive birth (parity 2) at Soroka University Medical Center, the only birth hospital in the area. Multiple gestations were excluded. RESULTS: The incidence of recurrent preterm delivery was 24.6% (362/1470) and it was not associated with having had prenatal care in the second pregnancy. In a multivariable logistic analysis, young maternal age, pregnancy complications and fetal abnormalities in the second pregnancy, as well as previous miscarriages, short inter-pregnancy interval, and length of gestation in the first pregnancy were significantly associated with recurrence. The incidence of adverse pregnancy outcomes (perinatal mortality, small for gestational age, gestational age <34 weeks, Apgar ≤ 7) in recurrent preterm delivery was 44.8% (162/362). Lack of prenatal care was significantly associated with adverse pregnancy outcomes (odds ratio: 4.03; 95% confidence interval: 2.04-7.97) in a multivariable logistic analysis controlling for all variables significantly associated with adverse pregnancy outcomes at the univariate analysis. CONCLUSIONS: Prenatal care may reduce the risk of adverse pregnancy outcomes in recurrent preterm delivery, even if recurrence cannot be prevented. It is therefore important that quality prenatal care is accessible to women who had a preterm delivery in the past.
OBJECTIVE: To assess the independent role of prenatal care in preventing recurrent preterm delivery (<37 weeks gestation) and in reducing adverse pregnancy outcomes in recurrent preterm delivery. STUDY DESIGN: A population-based retrospective cohort study. Participants were 1470 Bedouin women in Southern Israel who at their first delivery (parity 1) gave birth preterm (<37 weeks) and had a consecutive birth (parity 2) at Soroka University Medical Center, the only birth hospital in the area. Multiple gestations were excluded. RESULTS: The incidence of recurrent preterm delivery was 24.6% (362/1470) and it was not associated with having had prenatal care in the second pregnancy. In a multivariable logistic analysis, young maternal age, pregnancy complications and fetal abnormalities in the second pregnancy, as well as previous miscarriages, short inter-pregnancy interval, and length of gestation in the first pregnancy were significantly associated with recurrence. The incidence of adverse pregnancy outcomes (perinatal mortality, small for gestational age, gestational age <34 weeks, Apgar ≤ 7) in recurrent preterm delivery was 44.8% (162/362). Lack of prenatal care was significantly associated with adverse pregnancy outcomes (odds ratio: 4.03; 95% confidence interval: 2.04-7.97) in a multivariable logistic analysis controlling for all variables significantly associated with adverse pregnancy outcomes at the univariate analysis. CONCLUSIONS: Prenatal care may reduce the risk of adverse pregnancy outcomes in recurrent preterm delivery, even if recurrence cannot be prevented. It is therefore important that quality prenatal care is accessible to women who had a preterm delivery in the past.
Authors: Barbara Almeida Soares Dias; Maria do Carmo Leal; Katrini Guidolini Martinelli; Marcos Nakamura-Pereira; Ana Paula Esteves-Pereira; Edson Theodoro Dos Santos Neto Journal: Rev Saude Publica Date: 2022-03-11 Impact factor: 2.106
Authors: Aline S Rocha; Rita de Cássia Ribeiro-Silva; Rosemeire L Fiaccone; Enny S Paixao; Ila R Falcão; Flavia Jôse O Alves; Natanael J Silva; Naiá Ortelan; Laura C Rodrigues; Maria Yury Ichihara; Marcia F de Almeida; Mauricio L Barreto Journal: BMC Med Date: 2022-04-08 Impact factor: 8.775