Year: 2017
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Preterm birth (PTB) at <37 weeks of gestation complicates 10% of pregnancies and requires accurate counseling regarding anticipated neonatal outcomes. PTB classification as spontaneous or indicated is commonly used to cluster PTB into subtypes, but whether neonatal outcomes differ by PTB subtype is unknown. We tested the hypothesis that neonatal morbidity differs based on subtype of PTB. METHODS: We performed a retrospective cohort study of live-born, non-anomalous preterm infants from 2004 to 2008. Spontaneous PTB was defined as PTB from spontaneous preterm labor or preterm rupture of membranes. Indicated PTB was defined as PTB from any maternal or fetal medical complication necessitating delivery. The primary outcome was a composite of early respiratory morbidity. Secondary outcomes included late composite respiratory morbidity and other neonatal morbidities. RESULTS: Of 1,223 preterm neonates, 60.9% were born after spontaneous PTB and 30.1% after indicated PTB. Composite early respiratory morbidity was significantly higher after indicated PTB versus spontaneous PTB (1.3, 95% confidence interval [CI] 1.2-1.4). Composite late respiratory morbidity (1.8, 95% CI 1.3-2.3) and neonatal death (2.8, 95% CI 1.5-5.1) were also significantly higher after indicated PTB versus spontaneous PTB. CONCLUSION: Neonatal respiratory outcomes and death differ according to PTB subtype. PTB subtype should be considered while counseling families and anticipating neonatal outcomes after PTB.
Source: American Journal of Perinatology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: March of Dimes Foundation, American Thoracic Society, Washington University in St. Louis, Children's Discovery Institute, Georgia Clinical and Translational Science Alliance, National Institutes of Health, McDonnell Center for Systems Neuroscience, National Heart, Lung, and Blood Institute, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Lipidomic Screening For Functional Surfactant Gene Mutations, G1485266116, G1940083670, G2052854178, G2802667429, PREDICTING FETAL ACIDEMIA WITH INTRAPARTUM ELECTRONIC FETAL HEART RATE MONITORING, G3496795954, G4019743181, SURFACTANT PATHWAY GENE VARIANTS AMONG INFANTS WITH RESPIRATORY DISTRESS SYNDROME, G482091879, Women's Reproductive Health Research Career Development Program at W.U., St Louis, Omics of Inflammatory Airway Diseases, Washington University Institute of Clinical and Translational Sciences, Reproductive Epidemiology Training Program at Washington University in St. Louis, Optimizing Management of the Second Stage of Labor: Multicenter Randomized Trial, G9000115080, G998918373
OpenAlex ID: W2769156407