Abstract
Objective To compare the risks of adverse maternal and neonatal outcomes associated with spontaneous (SPTB) versus indicated preterm births (IPTB). Methods A secondary analysis of a multicenter trial of vitamin C and E supplementation in healthy low-risk nulliparous women. Outcomes were compared between women with SPTB (due to spontaneous membrane rupture or labor) and those with IPTB (due to medical or obstetric complications). A primary maternal composite outcome included: death, pulmonary edema, blood transfusion, adult respiratory distress syndrome (RDS), cerebrovascular accident, acute tubular necrosis, disseminated intravascular coagulopathy, or liver rupture. A neonatal composite outcome included: neonatal death, RDS, grades III or IV intraventricular hemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), or retinopathy of prematurity. Results Of 9,867 women, 10.4% (N = 1,038) were PTBs; 32.7% (n = 340) IPTBs and 67.3% (n = 698) SPTBs. Compared with SPTB, the composite maternal outcome was more frequent in IPTB-4.4% versus 0.9% (adjusted odds ratio [aOR], 4.0; 95% confidence interval [CI], 1.4-11.8), as were blood transfusion and prolonged hospital stay (3.2 and 3.7 times, respectively). The frequency of composite neonatal outcome was higher in IPTBs (aOR, 1.8; 95% CI, 1.1-3.0), as were RDS (1.7 times), small for gestational age (SGA) < 5th percentile (7.9 times), and neonatal intensive care unit (NICU) admission (1.8 times). Conclusion Adverse maternal and neonatal outcomes were significantly more likely with IPTB than with SPTB.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 624-631 |
| Number of pages | 8 |
| Journal | American journal of perinatology |
| Volume | 35 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jun 1 2018 |
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Keywords
- indicated preterm birth
- preeclampsia
- pregnancy outcomes
- spontaneous preterm birth
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology
Cite this
}
Adverse Maternal and Neonatal Outcomes in Indicated Compared with Spontaneous Preterm Birth in Healthy Nulliparas : A Secondary Analysis of a Randomized Trial. / Tita, Alan T.; Doherty, Lindsay; Roberts, Jim M.; Myatt, Leslie; Leveno, Kenneth J.; Varner, Michael W.; Wapner, Ronald J.; Thorp, John M.; Mercer, Brian M.; Peaceman, Alan M; Ramin, Susan M.; Carpenter, Marshall W.; Iams, Jay; Sciscione, Anthony; Harper, Margaret; Tolosa, Jorge E.; Saade, George R.; Sorokin, Yoram.
In: American journal of perinatology, Vol. 35, No. 7, 01.06.2018, p. 624-631.Research output: Contribution to journal › Article
TY - JOUR
T1 - Adverse Maternal and Neonatal Outcomes in Indicated Compared with Spontaneous Preterm Birth in Healthy Nulliparas
T2 - A Secondary Analysis of a Randomized Trial
AU - Tita, Alan T.
AU - Doherty, Lindsay
AU - Roberts, Jim M.
AU - Myatt, Leslie
AU - Leveno, Kenneth J.
AU - Varner, Michael W.
AU - Wapner, Ronald J.
AU - Thorp, John M.
AU - Mercer, Brian M.
AU - Peaceman, Alan M
AU - Ramin, Susan M.
AU - Carpenter, Marshall W.
AU - Iams, Jay
AU - Sciscione, Anthony
AU - Harper, Margaret
AU - Tolosa, Jorge E.
AU - Saade, George R.
AU - Sorokin, Yoram
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Objective To compare the risks of adverse maternal and neonatal outcomes associated with spontaneous (SPTB) versus indicated preterm births (IPTB). Methods A secondary analysis of a multicenter trial of vitamin C and E supplementation in healthy low-risk nulliparous women. Outcomes were compared between women with SPTB (due to spontaneous membrane rupture or labor) and those with IPTB (due to medical or obstetric complications). A primary maternal composite outcome included: death, pulmonary edema, blood transfusion, adult respiratory distress syndrome (RDS), cerebrovascular accident, acute tubular necrosis, disseminated intravascular coagulopathy, or liver rupture. A neonatal composite outcome included: neonatal death, RDS, grades III or IV intraventricular hemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), or retinopathy of prematurity. Results Of 9,867 women, 10.4% (N = 1,038) were PTBs; 32.7% (n = 340) IPTBs and 67.3% (n = 698) SPTBs. Compared with SPTB, the composite maternal outcome was more frequent in IPTB-4.4% versus 0.9% (adjusted odds ratio [aOR], 4.0; 95% confidence interval [CI], 1.4-11.8), as were blood transfusion and prolonged hospital stay (3.2 and 3.7 times, respectively). The frequency of composite neonatal outcome was higher in IPTBs (aOR, 1.8; 95% CI, 1.1-3.0), as were RDS (1.7 times), small for gestational age (SGA) < 5th percentile (7.9 times), and neonatal intensive care unit (NICU) admission (1.8 times). Conclusion Adverse maternal and neonatal outcomes were significantly more likely with IPTB than with SPTB.
AB - Objective To compare the risks of adverse maternal and neonatal outcomes associated with spontaneous (SPTB) versus indicated preterm births (IPTB). Methods A secondary analysis of a multicenter trial of vitamin C and E supplementation in healthy low-risk nulliparous women. Outcomes were compared between women with SPTB (due to spontaneous membrane rupture or labor) and those with IPTB (due to medical or obstetric complications). A primary maternal composite outcome included: death, pulmonary edema, blood transfusion, adult respiratory distress syndrome (RDS), cerebrovascular accident, acute tubular necrosis, disseminated intravascular coagulopathy, or liver rupture. A neonatal composite outcome included: neonatal death, RDS, grades III or IV intraventricular hemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), or retinopathy of prematurity. Results Of 9,867 women, 10.4% (N = 1,038) were PTBs; 32.7% (n = 340) IPTBs and 67.3% (n = 698) SPTBs. Compared with SPTB, the composite maternal outcome was more frequent in IPTB-4.4% versus 0.9% (adjusted odds ratio [aOR], 4.0; 95% confidence interval [CI], 1.4-11.8), as were blood transfusion and prolonged hospital stay (3.2 and 3.7 times, respectively). The frequency of composite neonatal outcome was higher in IPTBs (aOR, 1.8; 95% CI, 1.1-3.0), as were RDS (1.7 times), small for gestational age (SGA) < 5th percentile (7.9 times), and neonatal intensive care unit (NICU) admission (1.8 times). Conclusion Adverse maternal and neonatal outcomes were significantly more likely with IPTB than with SPTB.
KW - indicated preterm birth
KW - preeclampsia
KW - pregnancy outcomes
KW - spontaneous preterm birth
UR - http://www.scopus.com/inward/record.url?scp=85036570731&partnerID=8YFLogxK
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U2 - 10.1055/s-0037-1608787
DO - 10.1055/s-0037-1608787
M3 - Article
VL - 35
SP - 624
EP - 631
JO - American Journal of Perinatology
JF - American Journal of Perinatology
SN - 0735-1631
IS - 7
ER -