Liran Hiersch1,2, Yael Pasternak2,3, Nir Melamed4, Moshe Meshulam2,5, Reut Shashar2, Eran Hadar2,5, Amir Aviram2,4, Yariv Yogev1,2, Eran Ashwal1,2. 1. Department of Obstetrics and Gynecology, Lis Hospital for Women, Sourasky Medical Center, Tel Aviv 3QJQ+3X, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 4R73+8Q, Israel. 3. Department of Obstetrics and Gynecology, Meir Medical Center, Kefar Sava 5VJW+W5, Israel. 4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada. 5. Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva 3VQ8+MP, Israel.
Abstract
Background: We aimed to explore the association of the number, order, gestational age and type of prior PTB and the risk of preterm birth (PTB) in the third delivery in women who had three consecutive singleton deliveries. Methods: A retrospective cohort study of all women who had three consecutive singleton births at a single medical center over a 20-year period (1994-2013). The primary outcome was PTB (<37 weeks) in the third delivery. Results: 4472 women met inclusion criteria. The rate of PTB in the third delivery was 4.9%. In the adjusted analysis, the risk of PTB was 3.5% in women with no prior PTBs; 10.9% in women with prior one PTB only in the first pregnancy; 16.2% in women with prior one PTB only in the second pregnancy; and 56.5% in women with prior two PTBs. A similar trend was observed when the outcome of interest was spontaneous PTB and when the exposure was limited to prior spontaneous or indicated PTB. Conclusions: In women with a history of PTB, the risk of recurrent PTB in subsequent pregnancies is related to the number and order of prior PTBs. These factors should be taken into account when stratifying the risk of PTB.
Background: We aimed to explore the association of the number, order, gestational age and type of prior PTB and the risk of preterm birth (PTB) in the third delivery in women who had three consecutive singleton deliveries. Methods: A retrospective cohort study of all women who had three consecutive singleton births at a single medical center over a 20-year period (1994-2013). The primary outcome was PTB (<37 weeks) in the third delivery. Results: 4472 women met inclusion criteria. The rate of PTB in the third delivery was 4.9%. In the adjusted analysis, the risk of PTB was 3.5% in women with no prior PTBs; 10.9% in women with prior one PTB only in the first pregnancy; 16.2% in women with prior one PTB only in the second pregnancy; and 56.5% in women with prior two PTBs. A similar trend was observed when the outcome of interest was spontaneous PTB and when the exposure was limited to prior spontaneous or indicated PTB. Conclusions: In women with a history of PTB, the risk of recurrent PTB in subsequent pregnancies is related to the number and order of prior PTBs. These factors should be taken into account when stratifying the risk of PTB.
Authors: Esme I Kamphuis; Anita C J Ravelli; Bouchra Koullali; Brenda Kazemier; Christianne J M de Groot; Ben Willem J Mol Journal: Eur J Obstet Gynecol Reprod Biol Date: 2018-06-11 Impact factor: 2.435
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