2008, Number 09
<< Back Next >>
Ginecol Obstet Mex 2008; 76 (09)
Maternal factors associated to prematurity
Osorno CL, Rupay AGE, Rodríguez CJ, Lavadores MAI, Dávila VJ, Echeverría EM
Language: Spanish
References: 47
Page: 526-536
PDF size: 198.83 Kb.
ABSTRACT
Background: Prematurity is the main cause of morbidity-mortality in developed countries newborns, and it is responsible of most none malformed newborn deaths, and half congenital neurological disability.
Objective: To determine the association between socio-economic, demographic, and obstetric maternal history, evolution of pregnancy, and premature delivery.
Material and method: A cohort of live newborns was studied at Centro Médico Nacional Ignacio García Téllez since January 1
st 2000 to December 31
st 2004, with birth weight of 500 g or higher. Premature newborns were considered cases and those with 37 weeks of gestational age or more were controls. Prematurity prevalence was compared with and without risk factors. For each studied history it was calculated odds ratio (OR) with 95% confidence interval (95%CI), and attributed fraction in exposed and in population.
Results: Prematurity rate observed was 11.9% (3,018/25,355). Most remarkable risk factors associated with prematurity are: illiterate mother (OR 1.54; 95%CI; 1.2-1.94), single mother, 36 years old or more (OR 1.81; 95%CI; 1.56-2.09), history of preterm delivery (OR 2.21; 95%CI; 1.54-3.16), multifetal pregnancy, obstetric morbidity (preeclampsia/eclampsia; OR 7.9; 95%CI; 6.6-9.4), gestational diabetes (OR 2.3; 95%CI; 1.75-2.92), urinary tract (OR 1.8; 95%CI; 1.56-1.96) and vaginal infection, premature rupture of membranes, oligohydramnios, polihydramnios (OR 4.48; 95%CI; 3.04-6.6), placenta previa, and abruptio placentae (OR 9.96; 95%CI; 5.62-17.7). There was not a gestational risk factor in 43% (1302/3018) of preterm deliveries.
Conclusions: Premature rupture of membranes and maternal morbidity during pregnancy were the most important risk factors of prematurity.
REFERENCES
Goldenberg RL. The management of preterm labor. Obstet Gynecol 2002;100:1020-37.
Langhoff-Roos J, Kesmodel U, Jacobsson B, Rasmussen S, Vogel I. Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study. BJM 2006;332:937-9.
Goldenberg RL, Rouse DJ. Prevention of premature birth. N Engl J Med 1998;339:312-20.
Pérez MJJ, Cobián LBE, Silva MCA. Factores de riesgo maternos y nacimiento pretérmino en un hospital en el occidente de México. Ginecol Obstet Mex 2004;73:142-9.
Ahued-Ahued JR. Prematurez, un enfoque perinatal. México: Editores de Textos Mexicanos. 2004;p:1
Osorno CL, Acosta MA, Dávila VJ, Rodríguez CJ y col. Mortalidad neonatal, perspectiva de 10 años en un centro perinatal regional en Mérida, Yucatán. I. Análisis de las tasas crudas, específicas. Ginecol Obstet Mex 2006;74:401-9.
Lieberman EM, Ryan KJ, Monson RR, Hoenbaum SC. Risk factors accounting for racial differences in the rate of premature birth. N Engl J Med 1987;317:743-8.
Shiono PH, Klebanoff MA. Ethnic differences in preterm and very preterm delivery. Am J Public Health 1986;76:1317-21.
Fraser AM, Brockert JE, Ward RRH. Association of young maternal age with adverse reproductive outcomes. N Engl J Med 1995;332:1113-7.
Romero MS, Quezada SCA, López BMD, Arroyo CLM. Efecto del riesgo en el hijo de madre con edad avanzada. Ginecol Obstet Mex 2002;70:295-302.
Pereira LS, Lira PJ, Ahued AR, García BCQ, Iturralde RPP, Arteaga GC. Morbilidad materna en embarazo en adolescentes. Ginecol Obstet Mex 2002;70:170-4.
Hein HA, Burmeister LF, Papke KR. The relationship of unwed status to infant mortality. Obstet Gynecol 1990;76:763-8.
Bennett T. Marital status and infant health outcomes. Soc Sci Med. 1992;35:1179-1187.
Cerón–Mireles P, Harlow SD, Sánchez-Carrillo CI. The risk of prematurity and small-for-gestational-age birth in México City: the effects of working conditions and antenatal leave. Am J Public Health 1996;86:825-31.
Misra DP, Strobino DM, Stashinko EE, Nagey DA, Nanda J. Effects of physical activity on preterm birth. Am J Epidemiol 1998;147:628-35.
Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 1987;65:663-737.
Shiono PH, Klebanoff MA, Rhoads GG. Smoking and drinking during pregnancy. JAMA 1986;255:82-4.
Sorensen TK, Dempsey JC, Xiao R, Frederick IO, et al. Maternal asthma and the risk of preterm delivery. Ann Epidemiol 203;13:267-72.
Sibai BM, Caritis SN, Hauth JC, MacPherson C, et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies: the National Institute of Child and Human Development Maternal-Fetal Medicine Units. Am J Obstet Gynecol 2000;183:1520-4.
Hillier SL, Nugent RT, Eschenbach DA, Krohon MA, et al. Association between bacterial vaginosis and preterm delivery of a low birth weight infant. N Engl J Med 1995;333:1727-37.
Romero R, Chaiworapongsa T, Kuivaniermi H, Tromp G. Bacterial vaginosis, the inflammatory response and the risk of preterm birth: a role for genetic epidemiology in the prevention of preterm birth. Am J Obstet Gynecol 2004;190:1509-19.
Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC III, et al. Editors. Williams Obstetrics. 21st ed. New York: McGraw Hill, 2001;p:780.
Carlini L, Somigliana E, Rossi G, Vefglia F, et al. Risk factor for spontaneous preterm birth: a northern Italian multicenter casecontrol study. Gynecol Obstet Invest 2002;53:174-80.
Ancel PY, Bréart G. Epidemilogie und risiko-factoren der frühgeburtlichkeit. Gynäkologe 2000;33:356-60.
Lee KG, Cloherty JP. Identifying the high risk newborn and evaluating gestational age, prematurity, postmaturity, large for gestational age, and small for gestational age infants. In: Cloherty JP, Eichenwald EC, Stark AR. Manual of Neonatal Care. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2004;pp:42-56.
Kim YJ, Lee BE, Park HS, Kang JG, et al. Risk factors for preterm birth in Korea. Gynecol Obstet Invest 2005;60:206-12.
Pita FS, Vila AMT, Carpente MJ. Determinación de factores de riesgo. Cad Aten Primaria 1997;4:75-8.
Goldenberg RL, Hauth JC, Andrews WW. Mechanisms of disease: intrauterine infection and preterm delivery. N Engl J Med 342;2000:1500-7.
Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal and mortality associated with adolescent pregnancy in Latin America: cross-sectional study. Am J Obstet Gynecol 2005;192:342-9.
Chen XK, Wen SW, Fleming N, Demissie K, et al. Teenage pregnancy and adverse birth outcomes; a large population based retrospective cohort study. Int J Epidemiol 2007:36(2):368-73.
Buescher PA. Racial disparities in birth outcomes increase with maternal age: recent data from North Carolina. N C Med J 2006;67:16-20.
Mercer BM, Goldenberg RL, Das A, Moawad AH, et al. The preterm prediction study: a clinical risk assessment system. Am J Obstet Gynecol 1996;174:1885-93.
Tekesin I, Eberhart HJ, Schaefer V, Wallweiner D, Schmidt S. Evaluation and validation of a new risk score (CLEOPATRA score) to predict the probability of premature delivery for patients with threatened preterm labor. Ultrasoud Obstet Gynecol 2005;26:699-706.
Coria-Soto IL, Bobadilla JL, Notzon F. The effectiveness of antenatal care in preventing intrauterine growth retardation and low birth weight due to preterm delivery. Int Qual Health Care 1996;8:13-20.
Sánchez-Nuncio HR, Pérez-Toga G, Pérez-Rodríguez P, Vázquez-Nava F. Impacto del control prenatal en la morbilidad y mortalidad neonatal. Rev Med Inst Mex Seguro Soc 2005;43:377-80.
Fiscella K. Does prenatal care improve birth outcomes? A critical review. Obstet Gynecol 1995;85:468-79.
Castelazo-Ayala L, Rodríguez-Argüelles J, Díaz del Castillo E, Urrusti-Sanz J. Factores de riesgo perinatal en la población adscrita al Instituto Mexicano del Seguro Social, investigación clínica y epidemiológica (1974-1976). México: Ediciones Instituto Mexicano del Seguro Social, 1977.
Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. Am J Obstet Gynecol 1990;163:460-5.
Flores-Nava G, Peña-Robles JA López-Padilla M, Gómez- Nájera RI, Escobedo Chávez E. Antecedentes perinatales y morbimortalidad del hijo de madre con preeclampsia severa. Perinatol Reprod Hum 1998;12:183-90.
Zhang J, Villar J, Sun W, Merialdi M, et al. Blood pressure dynamics during pregnancy and spontaneous preterm birth. Am J Obstet Gynecol 2007;197:162;1-6.
Hollingsworth DR, Vaucher Y, Yamamoto TR. Diabetes in pregnancy in Mexican Americans. Diabetes Care 1991;14;695-705.
Forsbach G, Vázquez-Lara J, Álvarez-García C, Vázquez-Rosales J. Diabetes y embarazo en México. Rev Invest Clin 1998;50:227.31.
Beltrán-Montoya J, Ávila-Vergara MA, Vadillo-Ortega F, Hernández- Guerrero C y col. Infección cervicovaginal como factor de riesgo de trabajo de parto prematuro. Ginecol Obstet Mex 2002;70:203-9.
Calderón-Guillén J, Vega-Malagón G, Velásquez-Tlapanco J, Morales-Carrera R, Vega-Malagón AJ. Factores de riesgo materno asociados a parto pretérmino. Rev Med IMSS 2005;43:339-342.
Mazor M, Ghezzi F, Maymon E, Shoham-Vardi I, et al. Polyhydramnios is an independent risk factor for perinatal mortality and intrapartum morbidity in preterm deliveries. Eur J Obstet Gynecol Reprod Biol 1996;70:41-7.
Leung TY, Chan LW, Leung TN, Lau TK. Risk and prediction of preterm delivery in pregnancies complicated by antepartum hemorrhage of unknown origin before 34 weeks. Gynecol Obstet Invest 2001;82:227-31.
Ancel PY. Perspectives in the prevention of premature birth. Eur J Obstet Gynecol Reprod Biology 2004;117S:S2-S5.