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Can We Predict Preterm Delivery Based on the Previous Pregnancy?

Tamar Wainstock1, Ruslan Sergienko1, Eyal Sheiner2

  • 1Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8489325, Israel.

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|April 30, 2021
PubMed
Summary
This summary is machine-generated.

Complications during a first pregnancy, even if it ends at term, increase the risk of preterm delivery (PTD) in a subsequent pregnancy. Identifying these early pregnancy complications can help predict future PTD risk.

Keywords:
perinatal mortalitypreeclampsiapregnancy complicationspreterm birthpreterm deliverysmall for gestational age

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Reproductive Health

Background:

  • Preterm delivery (PTD) affects 5-18% of global births, causing significant offspring morbidity and healthcare costs.
  • Identifying risk factors for subsequent PTD is crucial for improving perinatal outcomes.
  • Previous PTD or early PTD (<34 weeks) are known risk factors, but factors from a prior term delivery are less understood.

Purpose of the Study:

  • To identify risk factors during a first pregnancy, ending at term, for preterm delivery (PTD) in the subsequent pregnancy.
  • To assess the association between specific first pregnancy complications and the risk of PTD in the second pregnancy.
  • To determine if early pregnancy complications can serve as a predictive window for future PTD.

Main Methods:

  • Retrospective population-based nested case-control study of women with two consecutive singleton deliveries.
  • Exclusion of women with PTD in the first pregnancy.
  • Multivariable logistic regression analysis adjusting for maternal age, interpregnancy interval, and comorbidities.

Main Results:

  • Of 39,780 women, 5.2% experienced PTD in their second pregnancy.
  • First pregnancy complications like perinatal mortality, small for gestational age, and preeclampsia were more common in women with subsequent PTD.
  • Any of these first pregnancy complications independently increased PTD risk (aOR=1.44), with two or more complications significantly elevating risk (aOR=2.09).

Conclusions:

  • Complications in a first pregnancy, even if delivered at term, are associated with an increased risk of preterm delivery in the subsequent pregnancy.
  • The first pregnancy serves as a critical window for identifying women at risk for future PTD.
  • Early identification and management of first pregnancy complications may help mitigate the risk of subsequent preterm deliveries.