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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Published on: August 25, 2014

The NICHD Consecutive Pregnancies Study: recurrent preterm delivery by subtype.

S Katherine Laughon1, Paul S Albert2, Kira Leishear3

  • 1Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD.

American Journal of Obstetrics and Gynecology
|September 17, 2013
PubMed
Summary
This summary is machine-generated.

Recurrent preterm birth risk is high, especially after spontaneous preterm delivery. Indicated preterm birth also increases the risk of subsequent preterm delivery, highlighting the need for more research.

Keywords:
indicated preterm birthrecurrent preterm birthspontaneous preterm birth

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Published on: January 12, 2018

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Epidemiology
  • Reproductive Health

Background:

  • Recurrent preterm delivery is a significant concern in maternal-newborn health.
  • Previous research has focused on spontaneous preterm delivery, with less attention to indicated preterm delivery.
  • Understanding recurrence risk across different preterm delivery subtypes is crucial for effective prevention strategies.

Purpose of the Study:

  • To investigate the association between prior preterm delivery subtypes and the risk of recurrent preterm delivery.
  • To compare recurrence rates for spontaneous, indicated, and elective preterm deliveries.
  • To identify specific risks associated with indicated preterm delivery for subsequent pregnancy outcomes.

Main Methods:

  • Retrospective cohort study of 51,086 pregnancies in Utah (2002-2010).
  • Binary relative risk regression was used to analyze the risk of preterm delivery (<37 weeks) in a second delivery based on the outcome of the first delivery.
  • Analyses were stratified by prior preterm delivery subtype: spontaneous, indicated, or no recorded indication, adjusting for multiple maternal factors.

Main Results:

  • The overall rate of recurrent preterm delivery was 30.7% among women who previously delivered preterm.
  • Prior spontaneous preterm delivery (PTD) was associated with a 5.64-fold increased risk of subsequent spontaneous PTD.
  • Prior indicated PTD showed a strong association with subsequent indicated PTD (RR 9.10) and an increased risk for subsequent spontaneous PTD (RR 2.70).

Conclusions:

  • Prior indicated preterm delivery is a strong predictor of subsequent indicated preterm delivery and also increases the risk of spontaneous preterm delivery.
  • Spontaneous preterm delivery exhibits the highest recurrence rate.
  • These findings suggest common underlying pathways for different preterm delivery etiologies and emphasize the need for increased focus on indicated preterm delivery recurrence risk.