Abstract
BackgroundPreterm birth is the main cause of morbidity and mortality during the perinatal period. Classical risk factors are held responsible for only 1/3 of preterm births and no current intervention has produced an appreciable reduction of this event. It is necessary to explore new hypotheses and mechanisms of causality by using an integrated approach, collaboration among research groups and less fragmented theoretical-methodological approaches in order to detect new risk factors and to formulate more effective intervention strategies.MethodsThe study will be conducted on a convenience cohort of Brazilian pregnant women recruited at public and private prenatal health services. A total of 1500 pregnant women in São Luís, and 1500 in Ribeirão Preto, will be invited for an interview and for the collection of biological specimens from the 22nd to the 25th week of gestational age (GA). At the time of delivery they will be reinterviewed. GA will be determined using an algorithm based on two criteria: date of last menstruation (DLM) and obstetric ultrasound (OUS) performed at less than 20 weeks of GA. Illicit drug consumption during pregnancy will be determined using a self-applied questionnaire and the following instruments will be used: perceived stress scale, Beck anxiety scale, screening for depression of the Center of Epidemiological Studies (CES-D), experiences of racial discrimination, social network and social support scale of the Medical Outcomes Study and violence (Abuse Assessment Screening and violence questionnaire of the WHO). Bacterial vaginosis, urinary tract infection and periodontal disease will also be identified. Neuroendocrine, immunoinflammatory and medical intervention hypotheses will be tested. The occurrence of elective cesarean section in the absence of labor will be used as a marker of medical intervention.ConclusionPsychosocial, genetic and infectious mechanisms will be selected, since there are indications that they influence preterm birth (PTB). The studies will be conducted in two Brazilian cities with discrepant socioeconomic conditions. The expectation is to identify risk factors for PTB having a greater predictive power than classically studied factors. The final objective is to propose more effective interventions for the reduction of PTB, which, after being tested, might subsidize health policies.Electronic supplementary materialThe online version of this article (doi:10.1186/1742-4755-11-79) contains supplementary material, which is available to authorized users.
Highlights
Preterm birth is the main cause of morbidity and mortality during the perinatal period
The etiology of Preterm birth (PTB) is not well known [8]. Gestational risk factors such as infections, multiple births, hypertension, smoking habit and the use of illicit drugs, exhausting work, low body mass index, insufficient weight gain, low maternal schooling, black race, and a history of preterm births have been demonstrated to be responsible for only one third of preterm deliveries [9,10]
gestational age (GA) will be determined using an algorithm based on two criteria: date of last menstruation (DLM) and obstetric ultrasound (OUS) performed at less than 20 weeks of GA
Summary
Preterm birth is the main cause of morbidity and mortality during the perinatal period. The etiology of PTB is not well known [8] Gestational risk factors such as infections, multiple births, hypertension, smoking habit and the use of illicit drugs, exhausting work, low body mass index, insufficient weight gain, low maternal schooling, black race, and a history of preterm births have been demonstrated to be responsible for only one third of preterm deliveries [9,10]. These conditions seem to be markers of more distal causes that need to be identified [11].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
