Preterm Birth

Preterm birth (less than 37 weeks of gestation) is a major cause of perinatal morbidity and mortality. A population-based retrospective cohort study analyzing 334,415 deliveries has examined the influences of various risk factors for extremely preterm birth (24-28 weeks of gestation) and if these changed between different sub-populations with known risk factors. Strongest risk factors for extremely preterm birth were: Placental abruption (OR = 20.606, 95%CI 17.006-24.969, p < 0.001) Multi-gestations (OR = 7.714, 95%CI 6.581-9.042, p < 0.001) Placenta previa (OR = 5.884, 95%CI 4.149-8.344, p < 0.001)   Risk factors for singleton extremely preterm birth included: Placental abruption (OR = 24.619, 95%CI 20.063-30.210, p < 0.001) Placenta previa (OR = 5.845, 95%CI 4.022-8.945, p < 0.001)) Previous preterm birth (OR = 2.305, 95%CI 1.980-2.784, p < 0.001) Nulliparity (OR = 2.226, 95%CI 1.902-2.605, p < 0.001) Lack of prenatal care (OR = 2.136, 95%CI 1.772-2.574, p < 0.001)   Among all groups, placental abruption was the strongest risk factor for extremely preterm birth whereas no significant difference on risk factors between sub-populations was observed

Omega-3 fatty acids, including docosahexaenoic acid (DHA) has been associated with reduced incidence of early preterm birth (less than 34 weeks) while the dose of DHA required is obscure. This study was conducted to examine the hypothesis that 1,000 mg DHA daily would be superior to 200 mg daily, a level in most prenatal supplements.

A Chinese study investigated the association between maternal protein status and risk of preterm birth together with gestational duration among urban populations. 3,382 mother-newborn pairs with data on maternal second-trimester plasma total protein (MTP) level and 3,478 mother-newborn pairs with data on maternal third-trimester MTP level were included in analysis. It was revealed that: >40% of the third-trimester MTP levels were smaller than the lower limit of normal while almost all second-trimester MTP levels were within the clinical reference range The third-trimester MTP levels were inversely associated with risk of preterm birth and were positively related with gestational duration while no significant association was noted for the second-trimester MTPs Influences of third-trimester MTP levels on risk of preterm birth and gestational duration were stronger in pregnant women with female offspring than those with male offspring