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Temporal Patterns in Preterm Birth Subtypes and Perinatal Survival, 2000-2023: Population-Based, Repeated

Ka Wang Cheung1,2, Tiffany Sin-Tung Au1, Tat On Chan1

  • 1Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.

BJOG : an International Journal of Obstetrics and Gynaecology
|January 27, 2026
PubMed
Summary
This summary is machine-generated.

Preterm birth (PTB) rates increased, but perinatal survival improved in Hong Kong. Subclassifying PTB reveals trends: spontaneous PTB without PPROM decreased, while PTB with PPROM and iatrogenic PTB increased.

Keywords:
low birth weightmortalityprematuritypreterm labourstillbirth

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Epidemiology
  • Public Health

Background:

  • Preterm birth (PTB) remains a significant concern globally, impacting perinatal survival.
  • Understanding the trends and causes of PTB is crucial for developing effective interventions.
  • Hong Kong's unique healthcare system provides an opportunity to study PTB patterns.

Purpose of the Study:

  • To evaluate the rate and trend of preterm birth (PTB) in Hong Kong from 2000 to 2023.
  • To assess the associated perinatal survival rates in relation to PTB.
  • To analyze PTB trends by subcategorizing spontaneous PTB (sPTB) and iatrogenic PTB (iPTB).

Main Methods:

  • A population-based, repeated cross-sectional time series study was conducted.
  • Data encompassed singleton and twin deliveries from all public maternity hospitals in Hong Kong (2000-2023).
  • Analyses included sPTB vs. iatrogenic PTB (iPTB), and further subclassification into sPTB without PPROM, PTB with PPROM, and iPTB.

Main Results:

  • Overall PTB rates increased for both singleton and twin pregnancies.
  • Subclassification revealed a downward trend in sPTB without PPROM, but significant increases in PTB with PPROM and iPTB.
  • PTB with PPROM and iPTB became leading causes of PTB; hypertensive disorders predominated iPTB. Neonatal mortality rates decreased for iPTB and overall for twin PTB.

Conclusions:

  • Perinatal survival has improved in Hong Kong despite rising PTB rates.
  • Interpreting PTB trends requires considering perinatal health indicators.
  • Categorizing PTB is essential for accurately reflecting and explaining population-level trends.