Obstetrical characteristics and neonatal outcome according to aetiology of preterm birth: a cohort study
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MATERNAL-FETAL MEDICINE
Obstetrical characteristics and neonatal outcome according to aetiology of preterm birth: a cohort study Isabelle Dehaene1 · Eline Scheire1 · Johan Steen2,3,4 · Kris De Coen5 · Johan Decruyenaere2 · Koenraad Smets5 · Kristien Roelens1 Received: 3 February 2020 / Accepted: 25 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Premature birth [MeSH] · Infant · Premature [MeSH] · Pregnancy complications [MeSH] · Biostatistics [MeSH] Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00404-020-05673-5) contains supplementary material, which is available to authorized users. * Isabelle Dehaene [email protected] 1
Ghent University Hospital, Obstetrics and Gynecology, Ghent, Belgium
2
Intensive Care, Ghent University Hospital, Ghent, Belgium
3
Renal Division, Ghent University Hospital, Ghent, Belgium
4
Departme
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