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Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort

Nathalie Auger1, Thi Uyen Nhi Le, Alison L Park

  • 1Institut National de Santé Publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, H2P-1E2, Canada. nathalie.auger@inspq.qc.ca

BMC Pregnancy and Childbirth
|October 6, 2011
PubMed

Insights

Maternal comorbidities significantly increase preterm birth (PTB) risk, with specific conditions linked to different PTB subtypes and gestational ages. Addressing reproductive system issues, preeclampsia, and anemia may help prevent spontaneous PTB and preterm premature rupture of membranes (PPROM).

Area of Science:

  • Reproductive Health
  • Perinatal Epidemiology
  • Maternal-Fetal Medicine

Background:

  • Preterm birth (PTB) is a leading cause of infant mortality and morbidity.
  • The association between maternal comorbidities and PTB, considering clinical subtypes and gestational age, is not well understood.

Purpose of the Study:

  • To evaluate the relationship between maternal comorbidities and PTB, categorized by clinical subtype and gestational age.

Main Methods:

  • A retrospective cohort study analyzed 1,329,737 singleton births in Québec, Canada (1989-2006).
  • PTB was classified by clinical subtype (medically indicated, PPROM, spontaneous preterm labor) and gestational age.
  • Polytomous logistic regression was used to estimate odds ratios for PTB subtypes associated with maternal comorbidities.

Main Results:

  • Mothers with comorbidities had higher PTB rates (10.9%) than those without (4.7%).
  • Reproductive system comorbidities were linked to spontaneous PTB; drug dependence and mental disorders were associated with PPROM and spontaneous PTB.
  • Placental abruption, chorioamnionitis, oligohydramnios, structural abnormalities, and cervical incompetence were major contributors to all PTB subtypes, particularly before 32 weeks.

Conclusions:

  • The link between comorbidity and PTB subtypes is gestational age-dependent.
  • Preventing PPROM and spontaneous PTB may require focusing on preeclampsia, anemia, and reproductive system comorbidities.
Abstract

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