Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study.

Salma Younes,Nader Al-Dewik,Sawsan Al-Obaidly,Rana Al-Jurf,Sara Hammuda,Mai Alqubaisi,Tawa Olukade,Hilal Al Rifai,Muthanna Samara,Thomas Farrell,Palli Valapila Abdulrouf,Ghassan Abdoh,Gheyath Nasrallah,Mohamed A Ismail,Husam Salama

doi:10.3390/ijerph18115865

Abstract

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar < 7 at 1 and 5 min and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

Highlights

Preterm birth (PTB) is considered the main cause of perinatal mortality and morbidity in industrialized countries [1]
Extreme to very PTB significantly predicted all assessed outcomes; low birth weight (LBW), small for gestational age (SGA), large for gestational age (LGA), caesarean delivery, low Apgar < 7 at 1 min and at 5 min, in-hospital mortality, and neonatal intensive care unit (NICU)/death in labor room (LR)/operation theatre (OT) in the univariate and the adjusted models (Tables 3 and S3)
Moderate PTB significantly predicted all assessed outcomes; LBW, SGA, LGA, caesarean delivery, low Apgar < 7 at 1 min and at 5 min, in-hospital mortality, and NICU/death in Labor Room/ Operation Theatre (LR/OT)

Summary

Introduction

Preterm birth (PTB) is considered the main cause of perinatal mortality and morbidity in industrialized countries [1]. A pregnancy that lasted anywhere between 37 and 42 weeks was referred to as a term pregnancy [9,10]. Driven by the growing body of evidence that significant differences exist in the outcomes of infants delivered within this 5-week interval, the definitions for term pregnancies have been updated [9,11]. In 2013, a full-term pregnancy (FTB) has been redefined as a pregnancy that lasts between weeks, 0 days and weeks 6 days, whereas the period between 37 weeks to 38 weeks, 6 days of gestation is referred to as early term birth (ETB) [9,11]. PTBs are not the only gestational age (GA) subgroup at risk of adverse clinical outcomes [12,13].

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Discussion

Conclusion