Should spontaneous and medically indicated preterm births be separated for studying aetiology?
- 22 March 2005
- journal article
- Published by Wiley in Paediatric and Perinatal Epidemiology
- Vol. 19 (2), 97-105
- https://doi.org/10.1111/j.1365-3016.2005.00637.x
Abstract
An increasing proportion of preterm births result from medical interventions, and the practice of aggregating all preterm births vs. splitting into spontaneous and medically indicated preterm births is inconsistent. While mechanistic and clinical arguments can be offered for either approach, we empirically evaluated the predictiveness of a range of risk factors for preterm birth in the Pregnancy, Infection, and Nutrition Study. Most influences were shared across the two subsets – African-American ethnicity, advancing age, delivery at a university medical centre, prior preterm birth and smoking. Medically indicated preterm births appeared to be associated with intensity of medical care, higher in the university medical centre and lower for the poorest women. Body mass index was positively associated with medically indicated preterm birth and inversely with spontaneous preterm birth. Given the complexity of the aetiological pathways, both aggregation and disaggregation are well justified and should be included in studies of the causes of preterm birth.Keywords
This publication has 21 references indexed in Scilit:
- Classification and heterogeneity of preterm birthBJOG: An International Journal of Obstetrics and Gynaecology, 2003
- Placental vascular compromise: Unifying the etiologic pathways of perinatal compromiseCurrent Problems in Obstetrics, Gynecology and Fertility, 2001
- Placental Abruption and Adverse Perinatal OutcomesJAMA, 1999
- Determinants of participation in an epidemiological study of preterm deliveryPaediatric and Perinatal Epidemiology, 1999
- Pregnancy Outcome and Weight Gain Recommendations for the Morbidly Obese WomanObstetrics & Gynecology, 1998
- Preeclampsia and Preterm Birth Subtypes in Nova Scotia, 1986 to 1992American Journal of Perinatology, 1997
- Pregnancy Complications and Birth Outcomes in Obese and Normal-Weight Women: Effects of Gestational Weight ChangeObstetrics & Gynecology, 1996
- For discussionPaediatric and Perinatal Epidemiology, 1995
- Fetal growth and the etiology of preterm deliveryObstetrics & Gynecology, 1995
- Epidemiologic characteristics of preterm delivery: Etiologic heterogeneityAmerican Journal of Obstetrics and Gynecology, 1991