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Investigação de trombofilias em gestantes de risco para o parto prematuro; Investigation of thrombophilias in high risk pregnant patients for preterm birth.

Rades, Érica
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/05/2007 PT
Relevância na Pesquisa
66.8%
Introdução: O parto prematuro espontâneo é doença multifatorial e sua etiologia permanece desconhecida em até 40% das vezes. Neste estudo, investigamos a existência de trombofilias maternas adquiridas e hereditárias em gestantes de risco para o parto prematuro espontâneo e as relacionamos com a incidência de prematuridade na gestação. Métodos: Neste estudo prospectivo, realizado entre julho de 2004 e setembro de 2006, foram pesquisadas 66 gestantes com antecedente de parto prematuro espontâneo e 66 gestantes sem antecedente de complicações, com pelo menos um parto a termo anterior. Até 25 semanas de gestação, foi realizada coleta única dos seguintes testes laboratoriais: anticardiolipina IgG, anticardiolipina IgM, anticoagulante lúpico, fator V Leiden, mutação da protrombina e homocisteína. Foram excluídas três gestantes por abortamento, duas por incompetência cervical, duas por malformação fetal, e uma por coleta inadequada. Dessa maneira, foram avaliadas 64 gestantes de risco e 60 sem complicações (grupo controle). Resultados: A incidência de prematuridade espontânea foi significantemente maior no grupo de risco (RR=7,97; IC95%=1,92-33,04, p<0,05). Não houve diferenças quanto ao tipo de parto nem quanto às médias dos pesos dos recém-nascidos entre os grupos. Entre as pacientes com antecedente de prematuridade...

Fatores associados ao nascimento pré-termo em Campina Grande/PB, Brasil: um estudo de caso-controle; Factors for preterm birth in newborn of hospital deliveries by mothers, residents in the city of Campina Grande/PB, Brazil: the study design was a case-control

Assunção, Paula Lisiane de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 26/08/2010 PT
Relevância na Pesquisa
66.64%
Introdução: A prevalência de nascimento pré-termo vem aumentando nos últimos anos e é atualmente um problema de saúde pública mundial, sendo responsável por significante mortalidade neonatal e morbidades infantil e na vida adulta. As causas são multifatoriais e estão relacionadas às dimensões socioeconômica, psicossocial e biológica que se interrelacionam e se sobrepõem. Os fatores de risco diferem entre as populações e grupos étnicos, no entanto, ainda não estão claros quais e como os determinantes etiológicos estão envolvidos. As estratégias de cuidado pré-natal desenvolvidas tem sido insuficientes para a prevenção. Objetivo: estudar os fatores de risco para o nascimento pré-termo em crianças nascidas de partos hospitalares de mães residentes no município de Campina Grande/PB, Brasil. Métodos: O desenho foi um caso-controle de base populacional, que foi realizado no período de junho de 2008 a maio de 2009. Os casos foram nascidos com menos de 37 semanas gestacionais e os controles os nascidos com 37 semanas ou mais. A idade gestacional foi definida em semanas utilizando-se critérios de seleção baseados na acurácia da estimativa. Foram realizadas entrevistas com as mães e coleta de registros hospitalares. Foram selecionados 341 casos e 424 controles. A análise foi baseada em modelo de regressão múltipla hierarquizada. Resultados: os fatores de risco para nascimento pré-termo foram: filho anterior pré-termo (OR=2...

Fatores de risco para nascimento pré-termo - uma análise com modelagem de equações estruturais; Risk factors of preterm birth - an analysis with structural equation modeling

Oliveira, Adelaide Alves de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 20/10/2014 PT
Relevância na Pesquisa
66.63%
Introdução: Um dos principais fatores associados à mortalidade e morbidade no período perinatal é o nascimento pré-termo. Sua prevalência está aumentando em diversas localidades e os motivos para tal envolve complexa inter-relação de fatores que incluem aspectos biológicos, de assistência, psicológicos, sociais e econômicos, entre diversos outros associados ao nascimento pré-termo. Objetivo: O presente estudo objetiva analisar os efeitos de variáveis associadas ao nascimento pré-termo, via modelagem de equações estruturais (MEE), com a construção de variáveis latentes de vulnerabilidade socioeconômica, familiar, psicossocial, condições maternas e intercorrências. Outros objetivos são analisar as diversas fontes de obtenção da idade gestacional (IG) visando gerar uma variável latente para a idade gestacional e comparar modelos com diferentes tipos de variável de desfecho (contínuo, ordinal, binário e latente). Métodos: Esse estudo foi baseado na pesquisa do tipo caso-controle populacional sobre nascidos vivos hospitalares de mães residentes na cidade de Londrina, estado do Paraná, realizado entre junho de 2006 e março de 2007. A partir de um modelo conceitual, foi empregada a MEE para construir modelos com variáveis latentes e compostas com utilização de medidas de ajustes. Resultados: O Modelo final apontou os seguintes efeitos diretos sobre IG: intercorrências...

Estudo multicêntrico de investigação em prematuridade no Brasil : implementação, correlação intraclasse e fatores associados à prematuridade espontânea = Multicenter study on preterm birth in Brazil: implementation, intracluster correlation and associated factors to spontaneous preterm birth; Multicenter study on preterm birth in Brazil : implementation, intracluster correlation and associated factors to spontaneous preterm birth

Giuliane Jesus Lajos
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 21/02/2014 PT
Relevância na Pesquisa
66.84%
Introdução: A prematuridade é um problema complexo de saúde pública, sendo a principal causa de morbidade e mortalidade neonatais, com tendência a aumento nas últimas décadas. Foi proposto um estudo com a participação de vários hospitais do Brasil, a fim de avaliar diversos aspectos envolvidos com a ocorrência do parto pré-termo. Objetivos: descrever os métodos de implementação do Estudo Multicêntrico de Investigação em Prematuridade no Brasil; avaliar a homogeneidade amostral dos casos incluídos; estimar a prevalência e analisar fatores associados à prematuridade espontânea. Métodos: estudo transversal multicêntrico, com componente caso-controle aninhado, em 20 hospitais de referência em três regiões geográficas do Brasil. Foram selecionadas as instituições participantes, elaborado o formulário de coleta de dados, escolhido o sistema eletrônico para inclusão de casos, desenvolvido um programa para a digitação dos dados, elaborados manuais de orientação e padronização da coleta de informações, seguidos de implantação do estudo e análise dos dados obtidos. Foi realizada vigilância prospectiva para identificação de partos pré-termo e estimada sua prevalência, subdividindo-os pelas condições determinantes: trabalho de parto espontâneo...

PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN

DOS REIS,Helena Lucia Barroso; ARAUJO,Karina da Silva; RIBEIRO,Lilian Paula; DA ROCHA,Daniel Ribeiro; ROSATO,Drielli Petri; PASSOS,Mauro Romero Leal; MERÇON DE VARGAS,Paulo Roberto
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2015 EN
Relevância na Pesquisa
66.67%
Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below...

Prepregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups

Parker, Margaret G; Ouyang, Fengxiu; Pearson, Colleen; Gillman, Matthew W; Belfort, Mandy B; Hong, Xiumei; Wang, Guoying; Heffner, Linda; Zuckerman, Barry; Wang, Xiaobin
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
66.62%
Background: To evaluate the association between prepregnancy body mass index (BMI) is associated with early vs. late and medically-induced vs. spontaneous preterm birth (PTB) subtypes. Methods: Using data from the Boston Birth Cohort, we examined associations of prepregnancy BMI with 189 early (<34 completed weeks) and 277 late (34–36 completed weeks) medically-induced PTBs and 320 early and 610 late spontaneous PTBs vs. 3281 term births (37–44 weeks) in multinomial regression. To assess for mediation by important pregnancy complications, we performed sequential models with and without hypertensive disorders of pregnancy, chorioamnionitis, and gestational diabetes. Results: Prevalence of prepregnancy obesity (BMI ≥ 30.0 kg/m2) was 28% among mothers with medically-induced PTBs, 18% among mothers with spontaneous PTBs, and 18% among mothers with term births (p = <0.001). After adjustment for demographic and known risk factors for PTB, prepregnancy obesity was associated with higher odds of both early [OR 1.78 (1.19, 2.66)] and late [OR 1.49 (1.09, 2.04)] medically-induced PTB. These effect estimates were attenuated with inclusion of hypertensive disorders of pregnancy and gestational diabetes. For spontaneous deliveries, prepregnancy obesity was associated with decreased odds of PTB (0.76 [0.58...

Sleep duration, vital exhaustion, and odds of spontaneous preterm birth: a case–control study

Kajeepeta, Sandhya; Sanchez, Sixto E; Gelaye, Bizu; Qiu, Chunfang; Barrios, Yasmin V; Enquobahrie, Daniel A; Williams, Michelle A
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
66.79%
Background: Preterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive. Methods: We examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (<37 weeks gestation) and 480 term controls who delivered a singleton infant at term (≥37 weeks gestation). Maternal nightly sleep and reports of vital exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous preterm labor or preterm premature rupture of membranes. In addition, cases were categorized as very (<32 weeks), moderate (32–33 weeks), and late (34- <37 weeks) preterm birth for additional analyses. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: After adjusting for confounders, we found that short sleep duration (≤6 hours) was significantly associated with preterm birth (aOR = 1.56; 95% CI 1.11-2.19) compared to 7–8 hours of sleep. Vital exhaustion was also associated with increased odds of preterm birth (aOR = 2.41; 95% CI 1.79-3.23) compared to no exhaustion (Ptrend <0.001). These associations remained significant for spontaneous preterm labor and preterm premature rupture of membranes. We also found evidence of joint effects of sleep duration and vital exhaustion on the odds of spontaneous preterm birth. Conclusions: The results of this case–control study suggest maternal sleep duration...

Interleukins-1, 4, -6, -10, tumor necrosis factor, transforming growth factor-β, FAS, and mannose-binding protein C gene polymorphisms in Australian women: risk of preterm birth; Interleukins-1, 4, -6, -10, tumor necrosis factor, transforming growth factor-beta, FAS, and mannose-binding protein C gene polymorphisms in Australian women: risk of preterm birth

Annells, M.; Hart, P.; Mullighan, C.; Heatley, S.; Robinson, J.; Bardy, P.; McDonald, H.
Fonte: Mosby Inc Publicador: Mosby Inc
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
66.7%
Objective: The purpose of this study was to examine the relationship between preterm birth and 22 single nucleotide polymorphisms in genes that encode cytokines and mediators of apoptosis and host defense. Study design: Two hundred two white women with a spontaneous preterm birth of <35 weeks of gestation were compared with 185 white women with term births. Genotyping was performed with polymerase chain reaction and sequence specific primers. Multivariable analyses included demographic and genetic variables. Results: Alcohol (multivariable odds ratio, 2.3; P = .001] and substance use (multivariable odds ratio, 3.7; P = .01) were associated with preterm birth at <35 weeks of gestation. Smoking (multivariable odds ratio, 2.3; P = .03), haplotypes IL10 -1082A/-819T/-592A (multivariable odds ratio, 2.1; P = .04), tumor necrosis factor (TNF)+488A/-238G/-308G (multivariable odds ratio, 2.4; P = .04), and IL4 -509C/C (multivariable odds ratio, 3.4; P = .02), and the presence of MBL2 codon 54Asp (multivariable odds ratio, 2.3; P = .02) were associated independently with preterm birth at <29 weeks of gestation. Homozygosity for IL10 -1082G/-819C/-592C haplotype (multivariable odds ratio, 1.9; P = .02) was more common in women with preterm premature rupture of membranes. Conclusion: Polymorphisms in immunoregulatory genes may influence susceptibility to preterm birth or premature rupture of membranes.

The effect of various infertility treatments on the risk of preterm birth

Wang, J.; Norman, R.; Kristiansson, P.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
66.7%
BACKGROUND: The high incidence of preterm birth (<37 weeks gestation) is a major concern in assisted reproductive technology. The objective of this study was to compare the risk of preterm birth from singleton pregnancies following either low technology treatment (intrauterine insemination and donor insemination) or high technology treatment (IVF, ICSI and gamete intra-Fallopian transfer) with that of naturally conceived pregnancies. METHODS: Three cohorts of pregnancies resulting from either low or high technology treatment or from natural conception were included in the study. A number of potential risk factors were adjusted for. RESULTS: The incidence of very preterm birth (<32 weeks of gestation) was not significantly increased in the low technology treatment group (1.0 versus 1.3% in controls) but was significantly higher in the high technology treatment group (5.2%, P < 0.001). In spontaneous, elective Caesarean section (CS) and induced delivery onset, the risk of preterm birth increased gradually from the controls to the low technology treatment group to the high technology treatment group, while for an emergency CS the risk of preterm birth was very high in both treatment groups. CONCLUSIONS: The overall incidence of preterm birth increased significantly from the controls to the low technology treatment group and to the high technology treatment group. Logistic regression analysis showed that younger and older age...

Australasian randomised trial to evaluate the role of maternal intramuscular dexamethasone versus betamethasone prior to preterm birth to increase survival free of childhood neurosensory disability (A*STEROID): Study protocol

Crowther, C.; Harding, J.; Middleton, P.; Andersen, C.; Ashwood, P.; Robinson, J.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.66%
BACKGROUND Both dexamethasone and betamethasone, given to women at risk of preterm birth, substantially improve short-term neonatal health, increase the chance of the baby being discharged home alive, and reduce childhood neurosensory disability, remaining safe into adulthood. However, it is unclear which corticosteroid is of greater benefit to mother and child. This study aims to determine whether giving dexamethasone to women at risk of preterm birth at less than 34 weeks’ gestation increases the chance of their children surviving free of neurosensory disability at two years’ corrected age, compared with betamethasone. METHODS/DESIGN Design randomised, multicentre, placebo controlled trial. Inclusion criteria women at risk of preterm birth at less than 34 weeks’ gestation with a singleton or twin pregnancy and no contraindications to the use of antenatal corticosteroids and who give informed consent. Trial entry & randomisation at telephone randomisation eligible women will be randomly allocated to either the dexamethasone group or the betamethasone group, allocated a study number and corresponding treatment pack. Study groups women in the dexamethasone group will be administered two syringes of 12 mg dexamethasone (dexamethasone sodium phosphate) and women in the betamethasone group will be administered two syringes of 11.4 mg betamethasone (Celestone Chronodose). Both study groups consist of intramuscular treatments 24 hours apart. Primary study outcome death or any neurosensory disability measured in children at two years’ corrected age. Sample size a sample size of 1449 children is required to detect either a decrease in death or any neurosensory disability from 27.0% to 20.1% with dexamethasone compared with betamethasone...

Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth

Schaaf, J.; Mol, B.; Abu-Hanna, A.; Ravelli, A.
Fonte: John Wiley Publicador: John Wiley
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
66.69%
Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999–2007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26–1.41) for African women, 1.58 (95% CI 1.47–1.69) for South-Asians, 0.88 (95% CI 0.84–0.91) for Mediterraneans and 1.04 (95% CI 0.98–1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41–0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75–0.99) when compared with European whites. Conclusions. African and South-Asian women are at higher risk for preterm birth than European white women. However...

Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007

Schaaf, J.; Mol, B.; Abu-Hanna, A.; Ravelli, A.
Fonte: Blackwell Science Publicador: Blackwell Science
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
66.84%
Objective.  Several studies have reported increasing trends in preterm birth in developed countries, mainly attributable to an increase in medically indicated preterm births. Our aim was to describe trends in preterm birth among singleton and multiple pregnancies in the Netherlands. Design.  Prospective cohort study. Setting.  Nationwide study. Population.  We studied 1 451 246 pregnant women from 2000 to 2007. Methods.  We assessed trends in preterm birth. We subdivided preterm birth into spontaneous preterm birth after premature prelabour rupture of membranes (pPROM), medically indicated preterm birth and spontaneous preterm birth without pPROM. We performed analyses separately for singletons and multiples. Main outcome measures.  The primary outcome was preterm birth, defined as birth before 37 weeks of gestation, with very preterm birth (<32 weeks of gestation) being a secondary outcome. Results.  The risk of preterm birth was 7.7% and the risk of very preterm birth was 1.3%. In singleton pregnancies, the preterm birth risk decreased significantly from 6.4% to 6.0% (P < 0.0001), mainly as a result of the decrease in spontaneous preterm birth without pPROM (3.6–3.1%, P < 0.0001). In multiple pregnancies, the preterm birth risk increased significantly (47.3–47.7%...

Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

Schaaf, J.; Hof, M.; Mol, B.; Abu-Hanna, A.; Ravelli, A.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
66.78%
Objective: To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton preterm birth. Design:  Cohort study. Setting: Nationwide study in the Netherlands. Population:  In all, 4071 nulliparous women who had a singleton delivery followed by a subsequent twin delivery between the years 1999 and 2007 were studied. Methods: Outcome of subsequent twin pregnancy of women with a history of preterm singleton delivery was compared with pregnancy outcome of women with a history of term singleton delivery. First deliveries were subdivided into iatrogenic and spontaneous preterm deliveries. Furthermore analyses were performed by subgroups for gestational age at the time of singleton delivery. Main outcome measure: Spontaneous preterm birth (<37 weeks of gestation) in subsequent twin pregnancy. Results:  In the index singleton pregnancy, preterm birth occurred in 232 (5.7%) of 4071 women. The risk of subsequent twin preterm birth was significantly higher after previous singleton preterm delivery (56.9 versus 20.9%; odds ratio 5.0; 95% CI 3.8–6.6). Risk of subsequent twin preterm birth was dependent on the severity of previous singleton preterm birth and was highest after preceding spontaneous instead of iatrogenic singleton preterm delivery. Conclusion: Preterm birth of a singleton gestation is associated with an increased risk of spontaneous preterm birth in a subsequent twin pregnancy.; JM Schaaf...

Development of a prognostic model for predicting spontaneous singleton preterm birth

Schaaf, J.; Ravelli, A.; Mol, B.; Abu-Hanna, A.
Fonte: Elsevier Ireland Publicador: Elsevier Ireland
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
66.73%
OBJECTIVE: To develop and validate a prognostic model for prediction of spontaneous preterm birth. STUDY DESIGN: Prospective cohort study using data of the nationwide perinatal registry in The Netherlands. We studied 1,524,058 singleton pregnancies between 1999 and 2007. We developed a multiple logistic regression model to estimate the risk of spontaneous preterm birth based on maternal and pregnancy characteristics. We used bootstrapping techniques to internally validate our model. Discrimination (AUC), accuracy (Brier score) and calibration (calibration graphs and Hosmer-Lemeshow C-statistic) were used to assess the model's predictive performance. Our primary outcome measure was spontaneous preterm birth at <37 completed weeks. RESULTS: Spontaneous preterm birth occurred in 57,796 (3.8%) pregnancies. The final model included 13 variables for predicting preterm birth. The predicted probabilities ranged from 0.01 to 0.71 (IQR 0.02-0.04). The model had an area under the receiver operator characteristic curve (AUC) of 0.63 (95% CI 0.63-0.63), the Brier score was 0.04 (95% CI 0.04-0.04) and the Hosmer Lemeshow C-statistic was significant (p<0.0001). The calibration graph showed overprediction at higher values of predicted probability. The positive predictive value was 26% (95% CI 20-33%) for the 0.4 probability cut-off point. CONCLUSIONS: The model's discrimination was fair and it had modest calibration. Previous preterm birth...

Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth

McCarthy, F.; Khashan, A.; North, R.; Rahma, M.; Walker, J.; Baker, P.; Dekker, G.; Poston, L.; McCowan, L.; O'Donoghue, K.; Kenny, L.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.73%
STUDY QUESTION Do women with a previous miscarriage or termination of pregnancy have an increased risk of spontaneous preterm birth and is this related to previous cervical dilatation and curettage? SUMMARY ANSWER A single previous pregnancy loss (termination or miscarriage) managed by cervical dilatation and curettage is associated with a greater risk of SpPTB. WHAT IS KNOWN ALREADY Miscarriage affects ∼20% of pregnancies and as many as a further 20% of pregnancies undergo termination. STUDY DESIGN, SIZE, DURATION We utilized data from 5575 healthy nulliparous women with singleton pregnancies recruited to the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study performed between November 2004 and January 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS The primary outcome was spontaneous preterm birth (defined as spontaneous preterm labour or preterm premature rupture of membranes (PPROM) resulting in preterm birth <37 weeks' gestation). Secondary outcomes included PPROM, small for gestational age, birthweight, pre-eclampsia and placental abruption. MAIN RESULTS AND THE ROLE OF CHANCE Women with previous pregnancy loss (miscarriage or termination) were compared with those with no previous pregnancy loss. There were 4331 (78%) women who had no previous pregnancy loss...

Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery

Schaaf, J.; Hof, M.; Mol, B.; Abu-Hanna, A.; Ravelli, A.
Fonte: Mosby Publicador: Mosby
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
66.65%
Objective: The purpose of this study was to investigate the recurrence risk of preterm birth (<37 weeks' gestation) in a subsequent singleton pregnancy after a previous nulliparous preterm twin delivery. Study Design: We included 1957 women who delivered a twin gestation and a subsequent singleton pregnancy from the Netherlands Perinatal Registry. We compared the outcome of subsequent singleton pregnancy of women with a history of preterm delivery to the pregnancy outcome of women with a history of term twin delivery. Results: Preterm birth in the twin pregnancy occurred in 1075 women (55%) vs 882 women (45%) who delivered at term. The risk of subsequent spontaneous singleton preterm birth was significantly higher after preterm twin delivery (5.2% vs 0.8%; odds ratio, 6.9; 95% confidence interval, 3.1–15.2). Conclusion: Women who deliver a twin pregnancy are at greater risk for delivering prematurely in a subsequent singleton pregnancy.; Jelle M. Schaaf, Michel H.P. Hof, Ben Willem J. Mol, Ameen Abu-Hanna, Anita C.J. Ravelli

Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review

Kazemier, B.M.; Buijs, P.E.; Mignini, L.; Limpens, J.; de Groot, C.J.; Mol, B.W.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
66.75%
BACKGROUND: Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. OBJECTIVES: To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. SEARCH STRATEGY: An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. SELECTION CRITERIA: Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. DATA COLLECTION AND ANALYSIS: The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. MAIN RESULTS: We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%)...

Use of anti-infective drugs during pregnancy : prevalence, predictors of use and the risk of preterm birth and small-for-gestational-age newborns

Santos, Fabiano
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
EN
Relevância na Pesquisa
66.69%
Résumé: Les anti-infectieux sont parmi les médicaments les plus utilisés pendant la grossesse. Les indications pour l’utilisation de ces médicaments, telles que les infections bactériennes, figurent parmi les facteurs de risque les plus importants pour la prématurité et les enfants nés petits pour l'âge gestationnel («Small-for-gestational-age », SGA). Ces complications de la grossesse peuvent avoir des incidences sur la santé du nouveau né et sur son développement futur. Compte tenu des impacts sur la santé de la mère et de l’enfant, la prise en charge et le traitement efficace de ces infections sont impératifs. Cependant, l'utilisation des anti-infectieux, pour éviter des issues de grossesse défavorables, fait l’objet d’une controverse dans la littérature. Cette controverse est en partie liée à la qualité méthodologique discutable des études disponibles sur le sujet. Les quatre études présentées dans cette thèse ont donc pour objectif d’investiguer l’utilisation des anti-infectieux durant la grossesse ainsi que d’évaluer le risque de prématurité et de SGA après utilisation de ces médicaments en période gestationnelle. Une révision systématique de la littérature sur l’utilisation du métronidazole durant la grossesse est également présentée. Nous avons utilisé...

Análise geográfica de nascimento pré-termo no estado de São Paulo, na RMSP e no município de São Paulo; Geographic analysis of preterm birth in the state of São Paulo, in the SPMA and São Paulo\'s municipality

Miranda, Marina Jorge de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 03/10/2014 PT
Relevância na Pesquisa
66.72%
A prematuridade é um dos grandes problemas de saúde pública, contribuindo com elevados números para a morbi-mortalidade infantil, principalmente em países em desenvolvimento como o Brasil. Conceitua-se o nascido prematuro ou pré-termo como aquele que nasce com menos de 37 semanas de gestação. Os fatores de risco individuais associados à incidência da prematuridade são conhecidos. No entanto, os fatores contextuais que podem influenciar na sua incidência têm sido pouco estudados. Sabe-se que a prematuridade é variável conforme a raça, as condições socioeconômicas, ambientais e culturais em que as mães estão inseridas. Assim, a presente tese teve por objetivo analisar o padrão da distribuição geográfica do risco relativo da prematuridade infantil em diferentes escalas: no estado de São Paulo, na Região Metropolitana de São Paulo e na esfera intra-urbana do município de São Paulo, durante o período de 2002 a 2007 (estado de SP), 2000 a 2010 (RMSP) e 2002 a 2013 (MSP) por meio da análise espacial exploratória. Investigamos como o contexto geográfico tem afetado o risco relativo de nascimentos pré-termo, através de testes de associação espacial global e local (I Moran e LISA) para estado de SP e para RMSP. Pela regressão multivariada global (OLS) e regressão geograficamente ponderada (GWS)...

The role of progesterone in prevention of preterm birth

Dodd, J.; Crowther, C.
Fonte: Dove Medical Press Ltd Publicador: Dove Medical Press Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
66.7%
Preterm birth continues to provide an enormous challenge in the delivery of perinatal health care, and is associated with considerable short and long-term health consequences for surviving infants. Progesterone has a role in maintaining pregnancy, by suppression of the calcium–calmodulin–myosin light chain kinase system. Additionally, progesterone has recognized anti-inflammatory properties, raising a possible link between inflammatory processes, alterations in progesterone receptor expression and the onset of preterm labor. Systematic reviews of randomized controlled trials evaluating the use of intramuscular and vaginal progesterone in women considered to be at increased risk of preterm birth have been published, with primary outcomes of perinatal death, preterm birth <34 weeks, and neurodevelopmental handicap in childhood. Eleven randomized controlled trials were included in the systematic review, involving 2714 women and 3452 infants, with results presented according to the reason women were considered to be at increased risk of preterm birth. While there is a potential beneficial effect in the use of progesterone for some women considered to be at increased risk of preterm birth, primarily in the reduction in the risk of preterm birth before 34 weeks gestation...