Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

Area of Science:

• Perinatal epidemiology
• Maternal-fetal medicine
• Public health

Background:

• Preterm birth (PTB) and early term birth (ETB) are linked to significant perinatal mortality and morbidity.
• Limited research exists on risk factors and outcomes for late PTB and ETB compared to extreme PTBs.
• Understanding these later-term births is crucial for improving neonatal care.

Purpose of the Study:

• To determine the incidence, risk factors, and feto-maternal outcomes of PTB and ETB in Qatar.
• To identify specific predictors for PTB and ETB.
• To inform clinical decision-making and risk assessment for these birth categories.

Main Methods:

• Retrospective analysis of 15,865 singleton live births from the PEARL-Peristat Study registry (12-month data).
• Statistical assessment of incidence rates, risk factors (maternal age, medical history, pregnancy assistance, birth abnormalities), and feto-maternal outcomes (birth weight, delivery mode, NICU admission, mortality).

Main Results:

• Incidence rates: PTB 8.8%, ETB 33.7%. In-hospital mortality: PTB 16.9%, ETB 0.2%.
• Independent predictors for both PTB and ETB included advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history.
• Chromosomal/congenital abnormalities predicted PTB but not ETB. Both PTB and ETB were associated with low birth weight (LBW), large for gestational age (LGA), cesarean delivery, and NICU/death.
• PTB also associated with small for gestational age (SGA), low Apgar scores, and in-hospital mortality.

Conclusions:

• PTB and ETB are common in Qatar, with significant associated risks including LBW, LGA, cesarean delivery, and NICU admission or mortality.
• Identifying specific risk factors like advanced maternal age and PGDM is vital for targeted interventions.
• Findings support enhanced clinical strategies for managing and predicting outcomes of PTB and ETB.