Am J Perinatol 2007; 24(8): 487-492
DOI: 10.1055/s-2007-986682
© Thieme Medical Publishers

The Contribution of Birth Defects to Spontaneous Preterm Birth

Carlos Grandi1 , Guillermo Luchtenberg1 , Monica Rittler2
  • 1Perinatal Epidemiology and Biostatistics Unit, Hospital Materno Infantil Ramón Sardá, Buenos Aires, Argentina
  • 2Medical Genetics Unit, Hospital Materno Infantil Ramón Sardá, Buenos Aires, Argentina
Further Information

Publication History

Publication Date:
14 September 2007 (online)

ABSTRACT

The purpose of this study was to determine if and which birth defects (BDs) are risk factors for spontaneous preterm delivery, and to quantify that risk. A case-control study of spontaneously delivered term (n = 21,093) and preterm (n = 2937; 12.2%) liveborn neonates, between 1996 and 2000, at Ramón Sardá Maternity Hospital of Buenos Aires, was performed. Selected risk factors were compared between term and preterm neonates, and risks of preterm birth in the presence of BDs were evaluated, using stratified and logistic regression analyses. Preterm versus term neonates showed higher rates of most of the selected maternal and neonatal risk factors. The prevalence of BDs among preterm and term neonates was 4.1 and 2.0%, respectively (p < 0.001). Newborns with BDs showed a higher adjusted risk for preterm birth than those without BDs (odds ratio, 2.16; 95% confidence interval, 1.92 to 2.40), with the highest risks for skeletal dysplasias, abdominal wall defects, chromosome, multiple, and minor anomalies. That neonates with BDs are at risk for spontaneous preterm birth, regardless of other factors, should lead to a readjustment of health policies aimed at the reduction of preterm delivery.

REFERENCES

  • 1 World Health Organization .Report of a Scientific Group on Health Statistics Methodology Related to Perinatal Events. Geneva; World Health Organization 1974: 1-32
  • 2 McCormick M C. The contribution of low birth weight to infant mortality and childhood morbidity.  N Engl J Med. 1985;  312 82-90
  • 3 Institute of Medicine .Preventing Low Birth Weight. Washington DC; National Academy Press 1985
  • 4 Ministerio de Salud .Programa Nacional de Estadísticas de Salud. Estadísticas Vitales 1995. Buenos Aires; Ministerio de Salud y Acción Social de la Argentina 1996 Serie 5, No. 39
  • 5 Goldenberg R L. The management of preterm labor.  Obstet Gynecol. 2002;  100 1020-1037
  • 6 Villar J, Ezcurra E. Preterm delivery syndrome: the unmet need. In: Keirse M New Perspectives for the Effective Treatment of Pre-Term Labour. An International Consensus. Research & Clinical Forums. United Kingdom; Wells Medical 16 1994: 9-33
  • 7 Grandi C, Pensotti A, Enríquez D, Larguía M. Estadísticas 2003 del Hospital Materno Infantil Ramón Sardá.  Rev Hosp Mat Infan Ramón Sardá. 2004;  23 190-200 Available at: http://www.sarda.org.ar/Home.asp
  • 8 Savitz D A, Blackmore C, Thorp J. Epidemiologic characteristics of preterm delivery: etiologic heterogeneity.  Am J Obstet Gynecol. 1991;  164 467-471
  • 9 Romero R, Sepulveda W, Baumann P. The preterm labour syndrome: biochemical, cytologic, immunologic, pathologic, microbiologic and clinical evidence that preterm labor is a heterogeneous disease. Paper presented at: Annual Meeting of the Society of Perinatal Obstetricians February 8-13, 1993 San Francisco, CA;
  • 10 Meis P J, Goldenberg R, Mercer B. The preterm prediction study: risk factors for indicated preterm births.  Am J Obstet Gynecol. 1998;  178 562-567
  • 11 Valenti E, Enríquez D, Larguía M. Parto prematuro provocado.  Rev Hosp Mat Infan Ramón Sardá. 2000;  19 72-77 Available at: http://www.sarda.org.ar/Home.asp
  • 12 Prazuck T, Tall F, Roisin A et al.. Risk factors for preterm delivery in Burkina Faso (West Africa).  Int J Epidemiol. 1993;  22 489-494
  • 13 Grandi C. Estudio de los factores de riesgo de nacimiento prematuro en una maternidad pública.  Medicina Infantil. 1995;  2 63 Available at: http://www.fundaciongarrahan.org.ar/publicaciones.htm
  • 14 Shaw G M, Savitz D A, Nelson V, Thorp Jr J M. Role of structural birth defects in preterm delivery.  Paediatr Perinat Epidemiol. 2001;  15 106-109
  • 15 Bakketeig L S, Hoffman H. Epidemiology of preterm birth. In: Elder M, Hendricks C Preterm Labour. London; Butterworth's International Medical Reviews 1981: 17-21
  • 16 Díaz A G, Schwarcz R, Díaz Rosello J, Simini F. Centro Latinoamericano de Perinatología y Desarrolo Humanos, editores. Sistema Informático Perinatal. Montevideo; Publicación Científica del CLAP No. 1203 OPS/OMS 1990
  • 17 Grandi C, Larguía A M. Contribución de la prematurez extrema, moderada y leve a la mortalidad neonatal.  Rev Hosp Mat Inf Ramón Sardá. 2003;  22 11-15 Available at: http://www.sarda.org.ar/Home.asp
  • 18 San Pedro M, Grandi C, Larguía M, Solana C. Estándar de peso para la edad gestacional en 55706 recién nacidos sanos de una maternidad pública de Buenos Aires.  Medicina (BAires). 2001;  61 15-22
  • 19 Kleinbaum D G. Modeling strategy guidelines. In: Kleinbaum DG Logistic Regression: A Self-Learning Text. New York; Springer-Verlag 1994: 161-190
  • 20 Altman D. Practical Statistics for Medical Research. 1st ed. London; Chapman & Hall 1991: 271-272
  • 21 Kahn H, Sempos Ch. Statistical methods. In: Epidemiology. New York; Oxford University Press 1989: 115
  • 22 Benichou J. A review of adjusted estimators of attributable risk.  Stat Methods Med Res. 2001;  10 195-216
  • 23 Linhart Y, Bashiri A, Maymon E et al.. Congenital anomalies are an independent risk factor for neonatal morbidity and perinatal mortality in preterm birth.  Eur J Obstet Gynecol Reprod Biol. 2000;  90 43-49
  • 24 Hartikainen-Sorri A L, Sorri M. Occupational and socio-medical factors in preterm birth.  Obstet Gynecol. 1989;  74 13-16
  • 25 Chen C P, Wang K, Yang Y, See L. Risk factors for preterm birth in an upper middle class Chinese population.  Eur J Obstet Gynecol Reprod Biol. 1996;  70 53-59
  • 26 Lockwood C J, Kuczynski E. Risk stratification and pathological mechanisms in preterm delivery.  Paediatr Perinat Epidemiol. 2001;  15(suppl 2) 78-89
  • 27 Wang X, Zuckerman B, Kaufman G et al.. Molecular epidemiology of preterm delivery: methodology and challenges.  Paediatr Perinat Epidemiol. 2001;  15(suppl 2) 63-77
  • 28 Aro T, Heinonen O, Saxen I. Risk indicators of reduction limb defects.  Int J Epidemiol Community Health. 1983;  37 50-56
  • 29 Gardosi J, Francis A. Early pregnancy predictors of preterm birth: the role of a prolonged menstruation-conception interval.  BJOG. 2000;  107 228-237
  • 30 Méhes K. Informative Morphogenetic Variants in the Newborn Infant. Budapest; Akadémiai Kiadó 1988: 5-7

Dr. Monica Rittler

Tucumán 3130, Olivos (1636)

Buenos Aires, Argentina

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