TY - JOUR
T1 - Risk factors for spontaneous preterm birth among healthy nulliparous pregnant women in the Netherlands, a prospective cohort study
AU - Schuster, Heleen J.
AU - Peelen, Myrthe J. C. S.
AU - Hajenius, Petra J.
AU - van Beukering, Monique D. M.
AU - van Eekelen, Rik
AU - Schonewille, Marit
AU - Playfair, Henna
AU - van der Post, Joris A. M.
AU - Kok, Marjolein
AU - Painter, Rebecca C.
N1 - Funding Information: We would like to thank all participating midwifery practices for all their efforts; Midwifery practice Bijlmermeer, Amsterdam, Midwifery practice De Eedenburgh, Hilversum, Midwifery practice Zonwaard, Heerhugowaard, Midwifery practice Lavita, Zaandam, Midwifery center Judith Govers, Huizen, Midwifery practice Helende Meesters Amstelveen, Amstelveen, Midwifery practice van der Hoopstraat, Amsterdam, Midwifery practice Amstelveen/Buitenveldert, Amstelveen, Midwifery practice Aalsmeer eo, Aalsmeer, Midwifery center Groei, Amsterdam, Midwifery practice Enkhuizen‐Andijk, Enkhuizen, Midwifery practice Poppie, Krommenie, Midwifery practice De Eerste Stap, Almere and midwives from Zorggroep Almere Team Groen en Team Geel, Almere. This study was funded by The Netherlands Organization for Health Research and Development (ZonMw, project number 209020002) and by the Amsterdam Reproduction and Development Institute (AR&D 2016). Neither ZonMw, nor AR&D had a role in the design of the study and collection, analysis, and interpretation of data and in writing of the manuscript. Funding Information: We would like to thank all participating midwifery practices for all their efforts; Midwifery practice Bijlmermeer, Amsterdam, Midwifery practice De Eedenburgh, Hilversum, Midwifery practice Zonwaard, Heerhugowaard, Midwifery practice Lavita, Zaandam, Midwifery center Judith Govers, Huizen, Midwifery practice Helende Meesters Amstelveen, Amstelveen, Midwifery practice van der Hoopstraat, Amsterdam, Midwifery practice Amstelveen/Buitenveldert, Amstelveen, Midwifery practice Aalsmeer eo, Aalsmeer, Midwifery center Groei, Amsterdam, Midwifery practice Enkhuizen-Andijk, Enkhuizen, Midwifery practice Poppie, Krommenie, Midwifery practice De Eerste Stap, Almere and midwives from Zorggroep Almere Team Groen en Team Geel, Almere. This study was funded by The Netherlands Organization for Health Research and Development (ZonMw, project number 209020002) and by the Amsterdam Reproduction and Development Institute (AR&D 2016). Neither ZonMw, nor AR&D had a role in the design of the study and collection, analysis, and interpretation of data and in writing of the manuscript. Publisher Copyright: © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Introduction: Spontaneous preterm birth (sPTB) is a major contributor to neonatal morbidity and mortality worldwide. The pathophysiology of sPTB is poorly understood, in particular among nulliparous women without apparent medical or obstetric risk factors. Therefore, we aimed to identify risk factors for sPTB in healthy nulliparous women. Material and Methods: We performed a prospective cohort study. Recruitment took place from February 2014 to December 2016 in 16 community midwifery centers in the Netherlands. Eligibility criteria were: ≥18 years, no previous pregnancy >16 weeks of gestation, healthy singleton pregnancy, and antenatal booking <24 weeks of gestation. At study inclusion, participants completed a questionnaire, including details on lifestyle, work, and medical history. Cervical length was measured by vaginal ultrasound at the second-trimester anomaly scan. Detailed information concerning pregnancy and birth was collected via antenatal charts. We calculated the adjusted odds ratio (aOR) and 95% confidence intervals (CI) for various risk factors with correction for socioeconomic status (SES) using logistic regression and Firth's correction. Results: We included 363 women of whom pregnancy outcomes were available in 349 (96.1%) participants. The cervical length measurement was available for 225 (62.0%) participants. sPTB occurred in 26 women (7.5%). SES was associated with sPTB (OR: 3.7, 95% CI: 1.6–8.5) in univariate analysis. First or second trimester vaginal bleeding (aOR: 3.6, 95% CI: 1.4–9.0) and urinary tract infection during pregnancy (aOR: 4.9, 95% CI: 1.7–13.9) were associated with sPTB in multivariate analysis. Conclusions: This prospective cohort confirms established risk factors for sPTB in nulliparous women deemed at low risk of sPTB.
AB - Introduction: Spontaneous preterm birth (sPTB) is a major contributor to neonatal morbidity and mortality worldwide. The pathophysiology of sPTB is poorly understood, in particular among nulliparous women without apparent medical or obstetric risk factors. Therefore, we aimed to identify risk factors for sPTB in healthy nulliparous women. Material and Methods: We performed a prospective cohort study. Recruitment took place from February 2014 to December 2016 in 16 community midwifery centers in the Netherlands. Eligibility criteria were: ≥18 years, no previous pregnancy >16 weeks of gestation, healthy singleton pregnancy, and antenatal booking <24 weeks of gestation. At study inclusion, participants completed a questionnaire, including details on lifestyle, work, and medical history. Cervical length was measured by vaginal ultrasound at the second-trimester anomaly scan. Detailed information concerning pregnancy and birth was collected via antenatal charts. We calculated the adjusted odds ratio (aOR) and 95% confidence intervals (CI) for various risk factors with correction for socioeconomic status (SES) using logistic regression and Firth's correction. Results: We included 363 women of whom pregnancy outcomes were available in 349 (96.1%) participants. The cervical length measurement was available for 225 (62.0%) participants. sPTB occurred in 26 women (7.5%). SES was associated with sPTB (OR: 3.7, 95% CI: 1.6–8.5) in univariate analysis. First or second trimester vaginal bleeding (aOR: 3.6, 95% CI: 1.4–9.0) and urinary tract infection during pregnancy (aOR: 4.9, 95% CI: 1.7–13.9) were associated with sPTB in multivariate analysis. Conclusions: This prospective cohort confirms established risk factors for sPTB in nulliparous women deemed at low risk of sPTB.
KW - bio-samples
KW - cohort profile
KW - nulliparous women
KW - risk factors
KW - spontaneous preterm birth
UR - http://www.scopus.com/inward/record.url?scp=85130624594&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/hsr2.585
DO - https://doi.org/10.1002/hsr2.585
M3 - Article
C2 - 35620540
SN - 2398-8835
VL - 5
SP - e585
JO - Health Science Reports
JF - Health Science Reports
IS - 3
M1 - e585
ER -