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ToolsSouza, Renato T., Costa, Maria L., Mayrink, Jussara, Feitosa, Francisco E., Rocha Filho, Edilberto A., Leite, Débora F., Vettorazzi, Janete, Calderon, Iracema M., Sousa, Maria H., Passini, Renato, Baker, Philip N., Kenny, Louise and Cecatti, Jose G. and The Preterm SAMBA study group* (2020) Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women. Scientific Reports, 10. ISSN 2045-2322
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Abstract
Preterm birth is the major contributor for neonatal and under-five 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 different categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in five 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 findings, Brazil would benefit from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term provider-initiated deliveries, and to prevent perinatal adverse outcomes.
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability: The dataset used and analysed during the current study is available from the corresponding author on reasonable request. Acknowledgements: This was one of the two big studies selected for sponsoring from the research call “Grand Challenges Brazil: Reducing the burden of preterm birth” number 05/2013 jointly issued by the Brazilian National Research Council (CNPq - Award 401636/2013–5) and the Bill and Melinda Gates Foundation (OPP1107597). The funders played no role at all in the study design, writing the manuscript nor in the decision to submit the manuscript for publication. |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 12 Jun 2025 10:30 |
| Last Modified: | 23 Jun 2025 09:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/99498 |
| DOI: | 10.1038/s41598-020-65022-z |
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