Risk Factors For Preterm Labor Research Articles

Methyl-CpG-binding protein 2 regulates CYP27A1-induced myometrial contraction during preterm labor.

Persistent and intense uterine contraction is a risk factor for preterm labor. We previously found that methyl-CpG-binding protein 2 (MeCP2), as a target of infection-related microRNA miR-212-3p, may play an inhibitory role in regulating myometrium contraction. However, the molecular mechanisms by which MeCP2 regulates myometrial contraction are still unknown. In this study, we found that MeCP2 protein expression was lower in myometrial specimens obtained from preterm labor cases, compared to those obtained from term labor cases. Herein, using RNA sequence analysis of global gene expression in human uterine smooth muscle cells (HUSMCs) following siMeCP2, we show that MeCP2 silencing caused dysregulation of the cholesterol metabolism pathway. Notably, MeCP2 silencing resulted in the upregulation of CYP27A1, the key enzyme involved in regulating cholesterol homeostasis, in HUSMCs. Methylation-specific PCR, chromatin immunoprecipitation, and dual luciferase reporter gene technology indicated that MeCP2 could bind to the methylated CYP27A1 promoter region and repress its transcription. Administration of siCYP27A1 in a lipopolysaccharide (LPS)-induced preterm labor mouse model delayed the onset of preterm labor. Human preterm myometrium and the LPS-induced preterm labor mouse model both showed lower expression of MeCP2 and increased expression of CYP27A1. These results demonstrated that aberrant upregulation of CYP27A1 induced by MeCP2 silencing is one of the mechanisms facilitating inappropriate myometrial contraction. CYP27A1 could be exploited as a novel therapeutic target for preterm birth.

Stress Ibu Selama Kehamilan Merupakan Risiko Persalinan Prematur

Under-five mortality in Southeast Sulawesi province is estimated to be more than 50% due to the risk of LBW, asphyxia, pneumonia, diarrhea and congenital abnormalities. The incidence of LBW with the most cases was found in South Konawe District with 266 infants out of a total of 5,796 births. The purpose of the study was to determine the causative factors of preterm labor at the South Konawe District Hospital, this research method is quantitative with an observational approach using a Case Control Study design, this research was conducted from February to March 2023 at the South Konawe District Hospital with a total sample of 116 respondents. The sampling technique for the condition group (Premature Labor) carried out in this study used a probability sample, namely Simple random sampling. The results of the study showed that stress has a risk of 11.22 times the incidence of preterm labor in South Konawe District Hospital. It is concluded that stress in pregnant women is a risk factor for preterm labor.

A Cross Sectional Study on Prevalence of Bacterial Vaginosis in Preterm and Term Labor

Background: The aim is to examine bacterial vaginosis (BV) in women with preterm and term labor, explore the link between bacterial vaginosis and preterm labor (PTL), and analyze complications for both mother and baby related to bacterial vaginosis. Design: Hospital based cross sectional study. Materials and Method: We had conducted an observational study at Basaveshwara Medical College and Hospital, involving 100 pregnant patients with preterm and term labor (50 patients in each group). Eligible patients attending the Obstetrics and Gynecology Outpatient Department (OBG OPD) and inpatient department will be included. Bacterial vaginosis will be determined using Amsel's criteria, which include evaluating discharge characteristics, vaginal pH, amine odor with KOH test, and presence of clue cells under microscopic examination. Additionally, vaginal swabs will undergo Gram staining. Results: The percentage of patients meeting Amsel's criteria for diagnosing bacterial vaginosis was significantly higher in the preterm labor group compared to the term labor group, with a statistically significant difference. According to Amsel's criteria, the prevalence of bacterial vaginosis was 30% in the preterm labor group and 2% in the term labor group. Conclusion: Bacterial vaginosis is a significant risk factor for preterm labor. Hence, conducting tests for bacterial vaginosis and promptly treating it can help reduce the risk of preterm labor.

Study of Cervical Mucus Cytology and Serum Inflammatory Biomarkers in Preterm Labour Compared to Term Pregnancy Cases in a Tertiary Care Center of Western Uttar Pradesh (UP), India.

The onset of labor prior to 37 weeks of gestation is preterm labor. Incidence ranges from 5% to 7% of live births in developed countries, but higher in developing countries (10-13%). Preterm birth is a major threat in perinatal health care, as well as a risk factor for neurological impairment and disability. Considering that infection is the major risk factor for preterm labor in rural areas, this study was performed to assess the cytological changes in the cervical mucus of normal-term and preterm labor cases. A hospital-based cross-sectional observational study was conducted in the Department of Obstetrics and Gynecology at a tertiary care center in western Uttar Pradesh (UP), India. The sample size calculated was 90. The neutrophil-to-lymphocyte ratio (NLR) in cervical mucus, along with serum inflammatory biomarkers such as CRP and serum alkaline phosphatase, were compared in both groups. The incidence of preterm labor increased with an increase in parity, and progression to preterm delivery is faster in the higher parity group. C-reactive protein (CRP) (pvalue= < 0.001) and serum alkaline phosphatases (taking 220IU/L as the cutoff value), as well as the NLR (pvalue < 0.001) in cervical mucus in preterm labor, are significantly higher than those in term labor cases, which can be used to predict preterm labor. Higher levels of serum alkaline phosphatase (> 220 IU/L) and CRP positivity can be used as prognostic markers. Using a cutoff value of 5 for the NLR in the cervical mucusof preterm labor patients proved to be a highly accurate predictor (82.2%) for preterm labor diagnosis.

Management of short cervix in twin-to-twin transfusion syndrome: a role for pessary placement following fetoscopic laser surgery?

Preterm labor and delivery is a major concern for patients with twin-to-twin transfusion syndrome undergoing fetoscopic laser surgery. A preoperative short cervix is a risk factor for preterm labor. Pessary placement is a short-acting intervention that may be useful to reduce this adverse event. This study aimed to investigate the relationship between pessary placement and preterm delivery in monochorionic twin pregnancies with twin-to-twin transfusion syndrome and a short cervix before fetoscopic laser surgery. This was a retrospective study in 2 centers, including all pregnancies affected by twin-to-twin transfusion syndrome that underwent fetoscopic laser surgery with the Solomon technique between 2013 and 2022 (center A) and 2014 and 2022 (center B) with a preoperative cervical length below 25 mm. This study explored the correlation between cervical length and fetoscopic laser surgery-to-delivery interval following active or expectant management and compared perinatal outcomes between patients managed expectantly and patients managed with pessary placement, using multivariate analysis to control for potential confounders. Patients with a cervical length below 5 mm were not included in the comparative analysis. Of 685 patients, 134 met the inclusion criteria. Moreover, 21 patients were treated with a cervical cerclage and excluded from the analysis, leaving 113 patients for the final analysis. There was a significant negative correlation between cervical length at fetoscopic laser surgery and the risk of early delivery (adjusted odds ratio, 0.66; 95% confidence interval, 0.49-0.81; P<.001). The use of a pessary correlated with fewer patients delivering before 28 weeks of gestation (adjusted odds ratio, 0.28; 95% confidence interval, 0.09-0.75), fewer double neonatal demise (adjusted odds ratio, 0.2; 95% confidence interval, 0.05-0.75). Posthoc subgroup analysis suggested that these improvements were essentially noticeable for cervical lengths between 5 and 18 mm, where pessary placement was associated with an increased fetoscopic laser surgery-to-delivery interval (+24 days; 95% confidence interval, 0.86-42; P=.042) and later gestational age at delivery (+3.3 weeks; 95% confidence interval, 0.86-42; P=.035). Patients with a moderately shortened cervix, between 5 and 18 mm, may benefit from pessary placement after fetoscopic surgery for twin-to-twin transfusion syndrome, resulting in a reduction of adverse neonatal outcomes, double neonatal demise, and severe preterm delivery.

High Apoptotic Index in Amniotic Membrane of Pregnant Women is A Risk Factor for Preterm Labor

This study aims to prove a high apoptotic index in the amniotic membrane as a risk factor for preterm Labor. Case-control study, comparing preterm and term groups (n=54) who underwent labor in Obstetrics Emergency Room, Sanglah Central General Hospital Denpasar, Bali. Apoptotic index is a method of identifying and assessing the quantity of tissue undergoing apoptosis, which in this study was the amniotic membrane tissue, calculated and stained using the TUNEL method. Data collected was subjected to further statistical tests. Normality test with Shapiro Wilk test, followed by parametric independent T-test and Mann Whitney test was performed. Cut off apoptotic index was determined using the Receiver Operating Characteristic (ROC) curve. Bivariate analysis with Chi-square test and calculation of odds ratio was performed to assess the high apoptotic index to the risk of preterm Labor. Statistical significance was obtained with p value &lt;0.05. Based on the cut-off value of ROC, the apoptotic index was classified into high (≥37.5%) and low (&lt;37.5%) apoptotic index. A high apoptotic index is a risk factor for preterm Labor and increases the risk 6 times greater than the group with a low apoptotic index (p=0.003; OR 5.714; 95% CI 1.764–18.507). High apoptotic index in the amniotic membranes of pregnant women is a risk factor for preterm Labor.

Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis.

Preterm birth is increasing worldwide, representing a major cause of death and long-term loss of human potential among survivors. Some morbidities during pregnancy are well-known risk factors for preterm labor, but it is not yet known whether deviations from adequate dietary patterns are associated with preterm delivery. Diet may be an important modulator of chronic inflammation, and pro-inflammatory diets during pregnancy were reported to be associated with preterm birth. The aim of this study was to assess the food consumption during pregnancy of Portuguese women giving birth very prematurely and the association between the food consumption and the major maternal morbidities during pregnancy related with preterm delivery. A single-center cross-sectional observational study including consecutive Portuguese women giving birth before 33 weeks of gestation was conducted. Recall of eating habits during pregnancy was obtained within the first week after delivery, using a semi quantitative food frequency questionnaire validated for Portuguese pregnant women. Sixty women with a median age of 36.0 years were included. Of these, 35% were obese or overweight at the beginning of pregnancy, 41.7% and 25.0% gained excessive or insufficient weight during pregnancy, respectively. Pregnancy-induced hypertension was present in 21.7% of cases, gestational diabetes in 18.3%, chronic hypertension in 6.7%, and type 2 diabetes mellitus in 5.0%. Pregnancy-induced hypertension was significantly associated with increased daily consumption of pastry products (31.2 vs 10.0 g, p = 0.022), fast food (39.6 vs 29.7 g, p = 0.028), bread (90.0 vs 50.0 g, p = 0.005), pasta, rice and potatoes (225.7 vs 154.3 g, p = 0.012). In a multivariate analysis, only bread consumption maintained a significant, albeit weak, association (OR = 1.021; 1.003 - 1.038, p = 0.022). Pregnancy-induced hypertension was associated with increased consumption of pastry products, fast food, bread, pasta, rice, and potatoes, although only bread consumption had a weak but statistically significant association with pregnancy-induced hypertension in a multivariate analysis.

Association of bacterial vaginosis with preterm labour

Background: Bacterial vaginosis is one of the most common presentation of women in their reproductive age group. Its prevalence is relatively high in the obstetric population which is mostly responsible for preterm delivery.Objective: To study association of preterm labour with bacterial vaginosis.Materials and Methods: This was a cross sectional study of 114 pregnant women attending department of obstetrics and gynaecology for a period of 6 months at Maharajahs Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh.Each woman after relevant history, investigations and examinations were studied for the presence of bacterial vaginosis (BV) based on Amsel’s criteria and followed up for birth weight of the neonates, neonatal admission in neonatal intensive care unit (NICU), neonatal complications and postpartum complications. Results: The mean maternal age and gestational age were 24.01±3.426 years and 31.658±1.709 weeks respectively. The proportion of patients who were diagnosed to have bacterial vaginosis according to Amsel’s criteria was 28.9%. Out of 81 BV negative women, there were 14 (17.2%) preterm deliveries compared to 67 (82.7%) term deliveries. However, out of 33 BV positive women, there were 26 (78.78%) preterm deliveries and 7 (2.21%) term deliveries. Highly significant with p value <0.00001. In the study, 84.8% of neonates born to BV positive mothers had low birth weight as compared to 65.4% of neonates born to BV negative mothers. NICU admission in BV positive patients was 48.48% as compared to 38.2%% in BV negative patient. However, 30.3% of neonates born to BV positive mothers had neonatal complications as compared to 16.04% of neonates born to BV negative mothers. Similarly, 42.42% of patients who were BV positive had postpartum complications as compared to 18.5% of patients who were BV negative.Conclusion: The association of bacterial vaginosis with preterm labour is quite frequent and it can be suggested that all symptomatic cases and those having risk factors for preterm labour should be screened for bacterial vaginosis.

Positive Expression of 3-Nitrotyrosine in The Amniotic Membrane as A Risk Factor for Preterm Labor

Oxidative stress is a risk factor for preterm labor. 3-Nitrotyrosine is a marker of oxidative stress that can be found in the amniotic membrane. This study was conducted with the aim of understanding the pathophysiology of preterm labor for screening and management of preterm labor and its impact. This study was conducted by collecting patients with preterm pregnancies as samples and term delivery as controls who came to the delivery room of the ER Obstetrics and Gynecology Hospital Prof. Dr. I.G.N.G. Ngoerah Denpasar and Network Hospital of Udayana University in the period from November 2020 to February 2021. This is an analytical study using a case control design. Based on the analysis, there was a statistically significant difference (p &lt; 0.001) between the case and control groups. The group of patients with positive 3-NT expression had an 8.31 times chance of experiencing preterm delivery compared to the group of patients with negative 3-NT expression.

Maternal risk factors for preterm labour

Maternal risk factors for preterm labour

العلاقة بين التهاب المسالك البولية والمخاض الباكر للنساء الحوامل في سوريا

Objective: The aim of this study is to determine the prevalence of urinary tract infection (UTI) in pregnant women with preterm labor. In addition to, estimating the association between UTI and occurrence of preterm labor. Patients and Methods: Descriptive Case- Control Study conducted for the period one year (June 2020 –June 2021) at Tishreen University Hospital in Lattakia- Syria. The study included 125 pregnant women without risk factors for preterm labor who were divided into case group (70): with preterm labor, and control group (55) with full term labor. Investigations for presence of UTI were performed in two groups. Results: The mean age was 25.5±5.3 years in the case group and 26.2±4.89 years in control group without significant difference. Previous history of preterm labor was more frequently in case group (17.5% vs.2.7%, p: 0.03). E.COLI was more frequently in the two groups. It was found that 16 patients (22.8%) in the case group and 4 patients (7.3%) in the control group had UTI with significant difference (p&lt;0.05). In the multivariate regression model, UTI was significantly associated with preterm labor (OR: 3.7[1.18- 12.05], P: 0.02. Conclusion: UTI is associated with the risk of preterm labor. Therefore, early detection and treatment of the infection can reduce effectively the risk of preterm labor.

ОСОБЕННОСТИ ЦИТОКИНОВОГО СТАТУСА ПРИ АКУШЕРСКИХ И ПЕРИНАТАЛЬНЫХ ОСЛОЖНЕНИЯХ У ЖЕНЩИН С ВНУТРИПЕЧЁНОЧНЫМ ХОЛЕСТАЗОМ БЕРЕМЕННЫХ

Background. Intrahepatic cholestasis of pregnancy (COP) is the most common complication of pregnancy that occurs during the 2nd-3rd trimester and is accompanied by liver damage manifested as cholestasis and cytolysis. Objective. To establish the role of cytokine response in the pathogenesis of COP as well as its obstetric and perinatal complications. Material and methods. 87 pregnant women were examined: 57 with intrahepatic cholestasis of pregnancy and 30 patients of the comparison group. The levels of pro-inflammatory (interleukin 6) and anti-inflammatory (interleukin 4) cytokines were determined by enzyme-linked immunosorbent assay, and their prognostic significance as predictors of obstetric and perinatal complications in women with COP was estimated. Results. The course of COP is accompanied by a decrease in the concentrations of IL-6 and IL-4 cytokines and a lower ratio of IL-4/IL-6 (P(U)IL-6=0.041; P(U)IL-4=0.0007 and P(U)IL4/IL-6=0.008). The concentration of IL-6 in blood serum that is &gt; 2.53 pg/ml (Se=83.3 %, Sp=73.9 %; AUC=0.822; 95 % CI 0.636–0.938; p=0.004) and IL-4 concentration that is &gt; 41.99 pg/ml in symptomatic COP (Se=100.0 %, Sp=78.6 %; AUC=0.839; 95 % CI 0.593–0.965; p=0.011) are regarded as a risk factor for preterm labor (PL) in women with COP. The concentration of IL-6 &gt; 3.07 pg/ml in women with COP and negative vaginal discharge culture can be considered as a predictor of meconium staining of amniotic fluid (MSAF) (Se=100.0 %, Sp=62.9 %; AUC=0.770; 95 % CI 0.597–0.895; p=0.024). Conclusions. COP is accompanied by a lower level of IL-6; an atypical immune deviation with no shift towards the Th2 immune response that is characteristic of a normal pregnancy; as well as an imbalance in the cytokine response with a decrease in the anti-inflammatory link. Preterm birth in patients with COP is associated with higher levels of IL-6 during pregnancy. The release of meconium into amniotic fluid in women with COP (in the absence of significant pathogenic and opportunistic microflora according to the results of vaginal discharge culture) correlates with higher concentrations of IL-6 in the blood.

High Maternal Cortisol Serum Levels as A Risk Factor for Preterm Labor

Preterm delivery is the leading cause of death for children under 5 years of age worldwide. Preterm delivery is one of the significant factors causing neonatal death due to complications associated with preterm birth. Complications of preterm delivery account for about 16% of all deaths in children under 5 years, and 35% of total deaths of newborns. There are several broad outlines of factors associated with preterm labor, including stress, inflammation or infection, overdistention of the uterus and the hypothalamic-pituitary-adrenal axis. Several studies show the role of cortisol caused by these factors. This study aimed to assess the relationship of maternal serum cortisol levels with the risk of preterm delivery. This study used a case-control design conducted at Sanglah Hospital, Denpasar from May to August 2021. A sample of 50 women was obtained which was divided into case groups and control groups. Serum cortisol examination used a 3 mL blood sample which was then examined using the ELISA method at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between high serum cortisol levels and the incidence of preterm labor in pregnant women (p &lt; 0.001; 95% CI; 2.768-38.22; OR 10.29). High cortisol serum levels can increase the risk of preterm labor 10 times in pregnant women when compared to pregnant women with low cortisol blood serum levels.

Frequency of anemia in patients with preterm labour.

Objective: To determine the frequency of anemia in pregnant women with preterm labour. Study Design: Cross Sectional Study. Setting: Department of Obstetrics &amp; Gynecology, Jinnah International Hospital (Teaching Hospital of Women Medical College), Abbottabad. Period: July 2020 to December 2020. Material &amp; Methods: The study comprised 171 females with a singleton pregnancy on ultrasound, gestational age of 24 to 37 weeks on ultrasound, parity 0-4 and preterm labour. Patients with history of cervical insufficiency, vaginal infection in last one year and urinary tract infection in last one year were excluded. Venous blood was collected from all 171 women in sodium EDTA tube by a 3rd year resident and was immediately sent to laboratory. Hemoglobin &lt; 9 g/dL was recorded as anemia. Results: The participants in this study ranged in age from 18 to 40 years, with mean age of 28.274±3.48 years, mean gestational age was 30.473±3.37 weeks, mean parity1.064±1.28 and mean weight was 73.836±9.74. Anemia was seen in 41.5% patients. Conclusion: The study gave us the information about the importance of iron deficiency anemia as a risk factor for preterm labor.

Is There a Difference in Femur Length Between Neglected Developmental Dysplasia of The Hip (DDH) And Contralateral Normal Hip-Femur Length?: A Radiographic Study

Background and Aim: There are several anatomical problems with the hip joint that are associated with developmental dysplasia (DDH), such as the femoral head being out of place in relation to the acetabulum. First-born status, female sex, a positive family history, breech presentation, and oligohydramnios are all risk factors for preterm labor and birth. DDH severity has been graded using a variety of classification systems, including the Crowe classification, the Hartofilakidis classification, and the Eftekhar and Kerboul classification. The purpose of this study was to determine whether there is a difference in femur length between patients with neglected developmental dysplasia of the hip (DDH) and the normal femur. Materials And Methods: This is a case series study of 14 patients with Unilateral DDH who did not have surgery. Between January 2017 and December 2020, data were retrieved and obtained from our hospital’s picture archiving and communication system (P.A.C.S). A Pelvis x-ray and a Full-Length Femur x-ray were taken for those patients. As a radiological landmark, a fulllength film from the tip of the greater trochanter to the intercondylar space was used in this study. The following were the inclusion criteria: 1. The patient must be an adult who is at least 18 years old. 2. The deformity should only occur on one side (Unilateral DDH). 3. They had never had surgery before. 4. Crowe types III and IV Results: The mean age of the patients was 34 (SD 12.4) years, with females outnumbering males (71.4 % vs 28.6 %). Additionally, the mean length of the affected femur was 41.6 (SD 3.88) and the mean length of the normal femur was 42.2. (SD 4.08). When we compared the baseline characteristics of patients by age group (35 years vs 35 years), we discovered that the BMI of the older age group (35 years) was statistically significantly higher than the younger age group (35 years) (P-value =0.028) Conclusion: As a result of our study, we found an approximately 1 to 2 cm difference in femur length between patients with unilateral DDH and normal hip, which was correlated with age and body mass index (BMI). Preoperative considerations for unilateral DDH include taking a long film of both femurs to determine their relative length differences. This will assist in determining the amount of subtrochanteric femoral osteotomy to perform.

437 Assessment of selected microbiological and immunological factors in pregnant women with a short cervix who were treated with pessary placement - preliminary report

Introduction and aim of the study: A short cervix diagnosed in the second trimester of pregnancy and abnormal vaginal biocenosis are the most important risk factors of preterm labor. Progesterone and cervical pessaries are used for treatment and prevention of preterm delivery. However, there are concerns, that pessary placement may impose a negative effect on the vaginal microbiota, leading to the development of pathogenic flora. The aim of the study was to assess whether progesterone treatment and the use of a pessary affect vaginal biocenosis in pregnant women with a short cervix.

High level of highly sensitivity c-reactive protein levels (hs-CRP) as a risk factor for preterm delivery

Introduction: Preterm labor is still a global problem because it affects perinatal morbidity and mortality, especially in developing countries. An increase in hs-CRP in pregnant women is associated with the incidence of preterm labor. This study was conducted to prove that high serum hs-CRP levels are a risk factor for preterm labor.Method: The method used in this study is an observational case-control study, in which pregnant women with preterm labor are in cases group, whereas preterm pregnant women that are not in labor, included in control group. Cases and controls were not matched in the gestational age variable. In both groups blood samples were taken. Blood sampling was taken in the cubital vein to examine the serum levels of hs-CRP. From the data collected, data analysis was performed using SPSS version 23.0. In this study, after the data normality test was performed using the Shapiro-Wilk test, the result p values &lt;0.05 or abnormal distribution data, the Mann Whitney test was chosen. A Chi-square test was performed to determine the increase in serum hs-CRP levels as a risk of preterm labor.Result: hs-CRP levels as a risk of preterm labor. Calculation of the OR is 19.46 times with 95% CI: 2.25–168.27.Conclusion: it can be concluded that high levels of hs-CRP as a risk factor for preterm labor.

Lower genital tract infections in preterm premature rupture of membranes and preterm labor: a case-control study from Vietnam

This study aimed to determine the incidence of lower genital infections and related factors in preterm premature rupture of membranes (PPROM) and preterm labor. A case-control study was conducted on pregnant women who were admitted to the Hospital of Hue University of Medicine and Pharmacy, Vietnam between November 2017 and May 2019. Cases from 22 to 36 gestational weeks were included as group 1 (patients with preterm labor and intact membranes) or as group 2 (those with PPROM). The control group included women with singleton pregnancies who were matched on gestational age and recruited concurrently with the study cases. Gram stain was perfomed to identify Lactobacillus, Gardnerella, mobiluncus, Candida, and leucocytes. Trichomonas vaginalis was detected by wet mount. Cultures of vaginal secretions and aminotic fluid were performed to identify aerobic bacteria. Bacterial vaginosis was higher in group 1 (28.9%) compared to control (11.4%). The incidence of isolated aerobic bacteria was 44.1% in group 2, 11.1% in group 1, and 12.7% in the control group (p < 0.001). Fungal infection was not shown to be a risk factor for preterm labor (p = 0.990), whereas, bacterial vaginosis was (OR = 3.16; 95%CI = 1.23-8.15; p = 0.016). Isolated aerobic bacteria were associated with premature rupture of membranes (OR = 5.45; 95%CI = 2.11-14.05; p < 0.001). Bacteria vaginosis increased the risk of preterm labor and preterm premature rupture of membranes. Isolated aerobic bacteria were related to PPROM, while fungal infection was not associated with preterm labor.

Risk Factor Evaluation of Preterm Labour/ Births in Rural Medical College Hospital

Introduction: Preterm Birth (PTB) is a major problem associated with neonatal morbidity and mortality globally. In developing countries magnitude of the problem is much more. Aim: The present study was undertaken to find out the incidence of preterm labour/births, to evaluate different related risk factors and to assess the neonatal mortality in PTBs. Materials and Methods: This cross-sectional study was conducted in a Maternal and Neonatal Units of Rural Teaching Hospital among all cases who delivered during study period of two months from mid-February 2019 to mid-April 2019. Probable maternal risk factors for preterm labour, neonatal clinical profile and risk factors for neonatal mortality were recorded. Frequencies and proportion of variables were computed. Results: The incidence of PTB/labour was 8.5%. Pregnancy duration of less than 34 weeks was observed in 35.6% mothers. It was observed that major factors contributing to PTBs were hypertensive disorders of pregnancy, maternal medical illness/severe anaemia, Bad Obstetric History (BOH)/ previous preterm labour and Ante-Partum Haemorrhage (APH). Survival rate amongst preterm babies was 90.5%. Conclusion: The morbidity amongst newborns is mainly caused by PTB. The study found lower incidence of PTB as compared to previous studies conducted in this region. Many of the risk factors evaluated are modifiable. Risk factor modifications and timely interventions will help in the reduction of PTBs and associated mortality.

Serum magnesium level as a predictive tool for preterm labour

Serum magnesium level in pregnancy is a valuable tool to find out preterm onset of labour. In the asymptomatic group, greater surveillance and administration of steroids, tocolytics and transfer to a higher centre wherever necessary has to be done with mothers with low serum magnesium level. Spontaneous preterm labor that is labor before 37 weeks of gestation is the main cause of preterm delivery. With increasing gestation the level of Serum magnesium levels decreases.A case-control study was carried out to evaluate serum magnesium levels and associated symptoms in women with preterm labour (28-36 weeks) and compare them with patients in same gestational age who delivered at term (37-40 weeks).Women in preterm labour had a significantly reduced serum magnesium level (mean 1.466 mg/dl with a S.D. of 0.077 versus 2.083 mg/dl with a SD of 0.105) for those delivered at normal magnesium levels.(p&amp;#60;0.05). The serum Magnesium level of preterm patients ranged from 1.32 to 1.60 mg/dl with mean Magnesium level of 1.466 ± 0.077 S.D. In normal pregnant women it ranged from 1.85 to 2.36 mg/dl with a mean Magnesium level of 2.083 ± 0.105 S.D which was highly significant (p&amp;#60;0.00001). The difference of serum Magnesium levels observed between the study population and control population is independent of factors like maternal age, parity, socio-economical status.The present study revealed significantly lower levels of serum magnesium in patients with preterm labour without any apparent cause as compared to normal pregnant women in labour. Hence, estimation of serum magnesium levels in pregnancy may be a useful parameter in preterm labour. The results of the present study add to the existing evidence that low serum magnesium level may be a risk factor for preterm labour.