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Matern Child Health J. 2018 Dec 11. doi: 10.1007/s10995-018-2658-z. [Epub ahead of print]

Previous Adverse Outcome of Term Pregnancy and Risk of Preterm Birth in Subsequent Pregnancy.

Author information

1
Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive MC0828, La Jolla, CA, 92093, USA. rjbaer@ucsd.edu.
2
The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA. rjbaer@ucsd.edu.
3
Department of Obstetrics and Gynecology, Sidney Kimmel Medical Center of Thomas Jefferson University, Philadelphia, PA, USA.
4
Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
5
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
6
The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA.
7
Departments of Epidemiology and Pediatrics, University of Iowa, Iowa City, IA, USA.
8
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
9
Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA.

Abstract

Objective Evaluate risk of preterm birth (PTB, < 37 completed weeks' gestation) among a population of women in their second pregnancy with previous full term birth but other adverse pregnancy outcome. Methods The sample included singleton live born infants between 2007 and 2012 in a birth cohort file maintained by the California Office of Statewide Health Planning and Development. The sample was restricted to women with two pregnancies resulting in live born infants and first birth between 39 and 42 weeks' gestation. Logistic regression was used to calculate the risk of PTB in the second birth for women with previous adverse pregnancy outcome including: small for gestational age (SGA) infant, preeclampsia, placental abruption, or neonatal death (≤ 28 days). Risks were adjusted for maternal factors recorded for second birth. Results The sample included 133,622 women. Of the women with any previous adverse outcome, 4.7% had a PTB while just 3.0% of the women without a previous adverse outcome delivered early (relative risk adjusted for maternal factors known at delivery 1.4, 95% CI 1.3-1.5). History of an SGA infant, placental abruption, or neonatal death increased the adjusted risk of PTB in their second birth by 1.5-3.7-fold. History of preeclampsia did not elevate the risk of a preterm birth in the subsequent birth. Conclusions for Practice The findings indicate that women with previous SGA infant, placental abruption, or neonatal death, despite a term delivery, may be at increased risk of PTB in the subsequent birth. These women may be appropriate participates for future interventions aimed at reduction in PTB.

KEYWORDS:

Neonatal death; Placental abruption; Poor adverse pregnancy outcome; Preterm birth; Small for gestational age

PMID:
30539421
DOI:
10.1007/s10995-018-2658-z

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