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Very preterm birth–a regional study. Part 1: Maternal and obstetric factors
Article first published online: 19 AUG 2005
DOI: 10.1111/j.1471-0528.1996.tb09711.x
Issue
1471-0528/asset/cover.gif?v=1&s=b4e1d96c46e18c61210d584b63c13ee375cf562b "BJOG: An International Journal of Obstetrics & Gynaecology")
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 103, Issue 3, pages 230–238, March 1996
Additional Information
How to Cite
Hagan, R., Benninger, H., Chiflings, D., Evans, S. and French, N. (1996), Very preterm birth–a regional study. Part 1: Maternal and obstetric factors. BJOG: An International Journal of Obstetrics & Gynaecology, 103: 230–238. doi: 10.1111/j.1471-0528.1996.tb09711.x
Publication History
- Issue published online: 19 AUG 2005
- Article first published online: 19 AUG 2005
- Received 10 October 1994 Returned to author for revision 18 January & 1 June 1995 Final revised version received 16 June 1995 Accepted 9 August 1995
- Abstract
- Article
- References
- Cited By
Objective To ascertain the demographic, pregnancy and obstetric factors associated with the delivery of a live born very preterm infant (< 33 weeks of gestation) and to investigate any differences in these factors between identifiable aetiological groups.
Design Cohort analytical study.
Setting King Edward Memorial Hospital for Women (KEMH), Western Australia.
Main variables examined Maternal demographic and obstetric history, primary complication associated with delivery, obstetric management and mode of delivery.
Results Six hundred and eight women who were delivered of 693 live born very preterm infants in Western Australia between 1.1.90 and 31.12.91, representing 1.22% of all women who were delivered of a live born infant in those years. Singleton pregnancy occurred in 517 (85%) and 541 (89%) were delivered in KEMH. Mean maternal age was 28 years with an excess of mothers less than 20 years of age and older than 34 years compared with the statewide perinatal data. Pre eclampsia (n= 128, 21.1 %), preterm prelabour rupture of membranes (n= 148, 24.3%), idiopathic preterm labour (n= 195, 30.4%) and antepartum haemorrhage (n= 111, 18.3%) were associated with 94.1% of deliveries. These proportions varied with plurality and period of gestation. Demographic details, use of antenatal steroids, exposure to labour and caesarean section delivery differed between mothers depending on the primary complication. Overall 322 (53.0%) received antenatal steroids and 297 (48.8%) were delivered by caesarean section. Factors associated with decreased use of steroids were gestational age of less than 27 weeks (odds ratio (OR) 0.54; 95% CI 0.36–0.83), preterm prelabour rupture of the membranes (OR 0.48; 95% CI 0.29–0.78) and idiopathic preterm labour (OR 0.56; 95% CI 0.35–0.91). Factors associated with increased use of steroids were multiple pregnancy (OR 1.70; 95% CI 1.02–2.41) and pre-eclampsia (OR 1.87; 95% CI 1.09–3.19).
Conclusions These very preterm deliveries account for only a small proportion of all deliveries. There are differences in the mother's demographic history, obstetric management and delivery depending on the primary aetiological factor.