Abstract:
PURPOSE:Preterm birth (PTB) can be categorised according to aetiology into: spontaneous preterm labour (SPL), preterm prelabour rupture of membranes (PPROM), and iatrogenic (iatro) PTB. Outcomes could differ between these groups, which could be of interest in counselling. We aimed to explore differences between aetiologic groups of PTB in maternal demographics, obstetrical characteristics and management, and neonatal outcomes. METHODS:This is a cohort study (2012-2018) in Ghent University Hospital, Belgium, of deliveries from 24 + 0 to 33 + 6 weeks. We compared perinatal demographics, management, and outcomes between the aetiologic types of PTB. Point and interval estimates for differences between aetiologic types were estimated using a Generalised Estimating Equations approach to handle clustering due to multiple gestations. RESULTS:813 mothers and 987 neonates were included. Prevalences of different aetiologic types of PTB were similar. Maternal BMI was higher in the iatrogenic group (iatro-SPL: + 1.92 kg/m2, 95% CI 1.02, 2.83; iatro-PPROM: + 2.06 kg/m2, 95% CI 1.15, 2.96). There was an inversed sex ratio (0.82, 95% CI 0.65, 1.03), more growth restriction (iatro-SPL: + 22.60%, 95% CI 17.08, 28.13; iatro-PPROM: + 24.64%, 95% CI 19.44, 29.83), and a higher caesarean section rate in the iatrogenic group (iatro-SPL: + 57.23%, 95% CI 50.32, 64.13, iatro-PPROM: + 56.79%, 95% CI 50.20, 63.38) and more patients received at least one complete course of antenatal corticosteroids (iatro-SPL: + 17.60%, 95% CI 10.60, 24.60, iatro-PPROM: + 10.73%, 95% CI 4.52, 16.94). In all types of PTB, adverse neonatal outcomes had a low prevalence, except for respiratory distress syndrome. A composite of adverse neonatal outcome was more prevalent in the SPL- compared to the PPROM group, and there was less intraventricular haemorrhage in the iatrogenic group. CONCLUSION:Additional to gestational age at birth, the aetiology of PTB is associated with neonatal outcome. More data are needed to enable individualised management and counselling in case of threatened PTB. TRIAL REGISTRATION NUMBER:NCT03405116.
journal_name
Arch Gynecol Obstetjournal_title
Archives of gynecology and obstetricsauthors
Dehaene I,Scheire E,Steen J,De Coen K,Decruyenaere J,Smets K,Roelens Kdoi
10.1007/s00404-020-05673-5subject
Has Abstractpub_date
2020-10-01 00:00:00pages
861-871issue
4eissn
0932-0067issn
1432-0711pii
10.1007/s00404-020-05673-5journal_volume
302pub_type
杂志文章abstract::The current management of patients with cervical polyps may include different approaches and protocols, such as a simply removal of the polyp in most cases at an office setting, surgical dilatation and curettage, electrosurgical excision or hysteroscopic polypectomy. Exploration of the cervical canal and uterine cavit...
journal_title:Archives of gynecology and obstetrics
pub_type: 杂志文章,评审
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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journal_title:Archives of gynecology and obstetrics
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