Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/220826 |
Resumo: | Preterm birth is the major contributor for neonatal and under-fve years mortality rates and also accounts for a short- and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with diferent categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in fve maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19–21weeks, 27–29 weeks and 37–39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37–38 weeks) were compared to full term birth (39–40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sPTB and pi-PTb were associated with poorer perinatal outcomes, as well as late sPTB, late pi-PTB and early term neonates. pi-PTB (RRadj 8.12, 95% CI [2.54–25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks <p10 (RRadj 2.04, 95% CI [1.23–3.38], p-value 0.018) and participants from the Northeast centres (RRadj 2.35, 95% CI [1.11–4.95], p-value 0.034) were independently associated with APO. According to our fndings, Brazil would beneft from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term providerinitiated deliveries, and to prevent perinatal adverse outcomes. |
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Souza, Renato TeixeiraCosta, Maria LauraMayrink, JussaraFeitosa, Francisco Edson de LucenaRocha Filho, Edilberto Alves Pereira daLeite, Debora Farias BatistaVettorazzi, JaneteCalderon, Iracema de Mattos ParanhosSousa, Maria Helena dePassini Júnior, RenatoBaker, Philip NewtonKenny, Louise C.Cecatti, Jose Guilherme2021-05-13T04:26:26Z20202045-2322http://hdl.handle.net/10183/220826001123196Preterm birth is the major contributor for neonatal and under-fve years mortality rates and also accounts for a short- and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with diferent categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in fve maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19–21weeks, 27–29 weeks and 37–39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37–38 weeks) were compared to full term birth (39–40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sPTB and pi-PTb were associated with poorer perinatal outcomes, as well as late sPTB, late pi-PTB and early term neonates. pi-PTB (RRadj 8.12, 95% CI [2.54–25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks <p10 (RRadj 2.04, 95% CI [1.23–3.38], p-value 0.018) and participants from the Northeast centres (RRadj 2.35, 95% CI [1.11–4.95], p-value 0.034) were independently associated with APO. According to our fndings, Brazil would beneft from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term providerinitiated deliveries, and to prevent perinatal adverse outcomes.application/pdfengScientific reports. London. Vol. 10 (2020), 8508, 11 p.Fatores de riscoTrabalho de parto prematuroGravidezMulheresPerinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous womenEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001123196.pdf.txt001123196.pdf.txtExtracted Texttext/plain54888http://www.lume.ufrgs.br/bitstream/10183/220826/2/001123196.pdf.txt5eb421507ef436be6d387938cce47815MD52ORIGINAL001123196.pdfTexto completo (inglês)application/pdf1319282http://www.lume.ufrgs.br/bitstream/10183/220826/1/001123196.pdf44f4136662366ef8d4323ce72a53a5eeMD5110183/2208262021-05-26 04:38:22.018053oai:www.lume.ufrgs.br:10183/220826Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2021-05-26T07:38:22Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
title |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
spellingShingle |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women Souza, Renato Teixeira Fatores de risco Trabalho de parto prematuro Gravidez Mulheres |
title_short |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
title_full |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
title_fullStr |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
title_full_unstemmed |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
title_sort |
Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women |
author |
Souza, Renato Teixeira |
author_facet |
Souza, Renato Teixeira Costa, Maria Laura Mayrink, Jussara Feitosa, Francisco Edson de Lucena Rocha Filho, Edilberto Alves Pereira da Leite, Debora Farias Batista Vettorazzi, Janete Calderon, Iracema de Mattos Paranhos Sousa, Maria Helena de Passini Júnior, Renato Baker, Philip Newton Kenny, Louise C. Cecatti, Jose Guilherme |
author_role |
author |
author2 |
Costa, Maria Laura Mayrink, Jussara Feitosa, Francisco Edson de Lucena Rocha Filho, Edilberto Alves Pereira da Leite, Debora Farias Batista Vettorazzi, Janete Calderon, Iracema de Mattos Paranhos Sousa, Maria Helena de Passini Júnior, Renato Baker, Philip Newton Kenny, Louise C. Cecatti, Jose Guilherme |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Souza, Renato Teixeira Costa, Maria Laura Mayrink, Jussara Feitosa, Francisco Edson de Lucena Rocha Filho, Edilberto Alves Pereira da Leite, Debora Farias Batista Vettorazzi, Janete Calderon, Iracema de Mattos Paranhos Sousa, Maria Helena de Passini Júnior, Renato Baker, Philip Newton Kenny, Louise C. Cecatti, Jose Guilherme |
dc.subject.por.fl_str_mv |
Fatores de risco Trabalho de parto prematuro Gravidez Mulheres |
topic |
Fatores de risco Trabalho de parto prematuro Gravidez Mulheres |
description |
Preterm birth is the major contributor for neonatal and under-fve years mortality rates and also accounts for a short- and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with diferent categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in fve maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19–21weeks, 27–29 weeks and 37–39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37–38 weeks) were compared to full term birth (39–40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sPTB and pi-PTb were associated with poorer perinatal outcomes, as well as late sPTB, late pi-PTB and early term neonates. pi-PTB (RRadj 8.12, 95% CI [2.54–25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks <p10 (RRadj 2.04, 95% CI [1.23–3.38], p-value 0.018) and participants from the Northeast centres (RRadj 2.35, 95% CI [1.11–4.95], p-value 0.034) were independently associated with APO. According to our fndings, Brazil would beneft from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term providerinitiated deliveries, and to prevent perinatal adverse outcomes. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2021-05-13T04:26:26Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/220826 |
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2045-2322 |
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001123196 |
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eng |
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Scientific reports. London. Vol. 10 (2020), 8508, 11 p. |
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openAccess |
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