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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
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Outcomes of Medically Indicated Preterm Births Differ by Indication
Michelle J Wang1, Spencer G Kuper1, Robin Steele1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, The University of Alabama at Birmingham, Birmingham, Alabama.
American Journal of Perinatology
|December 30, 2017
Summary
Preterm birth outcomes worsen when delivery is indicated by fetal or obstetric issues rather than maternal conditions. This highlights the need for tailored counseling based on delivery reasons.
Area of Science:
- Neonatalogy
- Obstetrics
- Perinatology
Background:
- Preterm birth (PTB) is a significant concern in neonatal care.
- Delivery indications can influence neonatal outcomes.
- Understanding these differences is crucial for improved patient management.
Purpose of the Study:
- To investigate if the reason for delivery modifies preterm birth outcomes.
- To compare neonatal outcomes based on maternal versus fetal/obstetric indications for delivery.
Main Methods:
- Retrospective cohort study of singletons delivered between 23 to 34 weeks gestation.
- Maternal indications included preeclampsia; fetal/obstetric indications included growth restriction, nonreassuring fetal status, and vaginal bleeding.
- Primary outcome was a composite of neonatal death and major morbidities; logistic regression adjusted for confounders.
Main Results:
- Women delivered for fetal/obstetric indications (25.2%) had a higher risk of the composite neonatal outcome compared to those delivered for maternal indications (74.8%) (aOR 1.9, 95% CI 1.13-3.21).
- Increased risk of acidemia at birth was observed in the fetal/obstetric group (aOR 4.2, 95% CI 1.89-9.55).
Conclusions:
- Preterm infants delivered for fetal/obstetric indications experience poorer outcomes than those delivered for maternal indications.
- Further research is warranted to personalize counseling based on the specific indication for delivery.
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