Maternal Morbidity Associated with Early Preterm Birth in Low-Risk Singleton Pregnancies

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Public Health

Background:

• Neonatal outcomes of early preterm birth are established, but maternal morbidity risks remain less understood.
• Investigating maternal complications associated with extreme and early preterm births is essential for comprehensive care.
• Existing research often overlooks the maternal health implications of preterm delivery.

Purpose of the Study:

• To evaluate the association between early preterm birth and maternal morbidities.
• To quantify the risk of specific maternal complications in preterm births compared to term births.
• To inform clinical practice regarding maternal risks in preterm deliveries.

Main Methods:

• Retrospective cohort study using the US Natality Live Birth database (2016-2021).
• Inclusion of low-risk singleton pregnancies, excluding high-risk conditions.
• Comparison of maternal morbidities across gestational age groups: extreme preterm (23-27 weeks), early preterm (28-33 weeks), and term (37-41 weeks).
• Multivariable logistic regression analysis to adjust for confounders, presenting adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Main Results:

• Analysis of 18,797,394 live births revealed significant associations.
• Extreme and early preterm births correlated with increased odds of maternal transfusion, uterine rupture, unplanned hysterectomy, and ICU admission.
• Conversely, odds of severe perineal lacerations were lower in preterm birth groups compared to term births.

Conclusions:

• Early and extreme preterm births are linked to significant maternal morbidities beyond neonatal concerns.
• Maternal risks include higher likelihoods of transfusion, uterine rupture, hysterectomy, and ICU admission.
• These findings underscore the need to consider maternal complications when managing preterm births.