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Kozma Bence (szülész-nőgyógyász)
Spontaneous and induced preterm birth have different obstetric characteristics and risk factors / Kozma Bence, Póka Róbert
Spontaneous and induced preterm births have different obstetric characteristics and risk factorsBence Kozma, Robert PokaDept. Obstet. Gynaecol. University of Debrecen, Medical and Health Science Center, HungaryIntroduction: Preterm birth (PTB) is often described as a single entity. Prevention is based on identification and elimination of risk factors that are observed in the entire pregnant population delivering before 37 weeks gestation. PTB is mostly viewed as an outcome despite the fact that, in many cases, it is a method of obstetric intervention to reduce fetal, maternal and neonatal morbidity and mortality. Therefore, we decided to test the notion that there might be important differences between spontaneous and induced cases of PTB with regards to both risk factors and outcome measures.Methods and patients: Retrospective analysis of 1500 consecutive cases was carried out by collecting demographic, obstetric and outcome data. PTB was defined as delivery before the 37th completed gestational week based on Naegele calculation corrected by first trimester CRL measurement. Comparisons were made between cases of spontaneous and induced deliveries. The delivery was considered spontaneous if tocolysis was required to attain time for fetal therapy or there was no need for measures aiming at cervical ripening or inducing uterine activity with oxytocin. Continuous variables were compared by t-test and the frequency of categorical variables were compared by ?2-test.Results: According to our selection criteria 571 cases were spontaneous and 929 cases were induced PTBs. The mean age and prepregnancy weight of patients with induced and spontaneous delivery were significantly different (30,2 vs 28,4 years; 68,8 vs 64,4 kg). There was no difference between the two groups in the number of spontaneous and artificial abortions. Among multiparous patients there was a significant difference in the frequency of previous Caesarean section between induced and spontaneous cases of PTB (82/163 vs 30/141). No differences were found between our groups with regards to history of hypertension, asthma, diabetes and renal disease but significantly more patients were smokers among cases with induced PTB (92/565 vs 227/916). In the index pregnancy, significantly more patients had preeclampsia in the induced group but there was no difference in the frequency of asthma, diabetes, renal disease and urinary tract infection. However, preterm premature rupture of membranes was significantly less common in the induced group then among spontaneous PTBs (213/571 vs 567/929). Caesarean frequency was significantly higher in the induced group compared to that in spontaneous PTBs (402/571 vs 312/928). Despite mean gestational age at birth was not different in the two groups (32,7 vs 33,0 weeks), the mean birthweight was significantly higher in the spontaneous group than in induced PTBs (2173 vs 1979 g).Conclusion: Induced PTBs have significantly different demographic and obstetric background as well as different outcome when compared to those of spontaneous PTBs. Our results show that a genome wide search for risk factors of preterm delivery may need to take these differences into account.
Biopolymers and Cell. - 27 (2011), p. 101. -
Póka Róbert (1960-) (szülész-nőgyógyász, klinikai onkológus)
Intézményi repozitóriumban (DEA) tárolt változat
Corvina könyvtári katalógus v8.2.27
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