Outcomes of Admissions for Preterm Labor

Overview

Journal AJP Rep

Date 2017 Jun 27

PMID 28649463

Citations 1

Authors

Michael W Kuzniewicz

Libby Black

Eileen M Walsh

Sherian X Li

Mara Greenberg

Affiliations

Soon will be listed here.

Abstract

This study aims to quantitate the incidence of preterm labor (PTL) admissions and determine the frequency and predictors of preterm delivery (PTD) during these admissions. Retrospective cohort of singleton pregnancies within Kaiser Permanente Northern California, 2001 to 2011. PTL admissions were defined as inpatient encounters > 24 hours with an International Classification of Diseases, 9th Revision code for PTL. Total study population was 365,897 with PTL admission rate 11%. PTD occurred in 85% of pregnancies with PTL admission. Delivery occurred within 48 hours of admission in 96% ≥34 weeks, 67% 31 to 33 weeks, and 51.9% <31 weeks. Predictors of delivery during PTL admission included gestational age 34 to 36 weeks (adjusted odds ratio [aOR], 6.90), chorioamnionitis (aOR, 105.58), and preterm rupture of membranes (aOR 19.29). We demonstrate a high rate of PTD per PTL admission in a highly integrated health care system. More work is needed to determine optimal practices for hospitalization and treatment of women diagnosed with PTL.

Citing Articles

Short and long-term costs among women experiencing preterm labour or preterm birth: the German experience.

Pokras S, Pimenta J, Merinopoulou E, Lambrelli D BMC Pregnancy Childbirth. 2018; 18(1):284.

PMID: 29973192 PMC: 6030749. DOI: 10.1186/s12884-018-1912-0.

References

Fuchs I, Henrich W, Osthues K, Dudenhausen J . Sonographic cervical length in singleton pregnancies with intact membranes presenting with threatened preterm labor. Ultrasound Obstet Gynecol. 2004; 24(5):554-7. DOI: 10.1002/uog.1714. View

Callaghan W, MacDorman M, Rasmussen S, Qin C, Lackritz E . The contribution of preterm birth to infant mortality rates in the United States. Pediatrics. 2006; 118(4):1566-73. DOI: 10.1542/peds.2006-0860. View

Henderson J, McWilliam O, Newnham J, Pennell C . Preterm birth aetiology 2004-2008. Maternal factors associated with three phenotypes: spontaneous preterm labour, preterm pre-labour rupture of membranes and medically indicated preterm birth. J Matern Fetal Neonatal Med. 2011; 25(6):642-7. DOI: 10.3109/14767058.2011.597899. View

Liu S, Heaman M, Sauve R, Liston R, Reyes F, Bartholomew S . An analysis of antenatal hospitalization in Canada, 1991-2003. Matern Child Health J. 2006; 11(2):181-7. DOI: 10.1007/s10995-006-0154-3. View

Scott C, Chavez G, Atrash H, Taylor D, Shah R, Rowley D . Hospitalizations for severe complications of pregnancy, 1987-1992. Obstet Gynecol. 1997; 90(2):225-9. DOI: 10.1016/S0029-7844(97)00230-5. View

Liggins G, Howie R . A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972; 50(4):515-25. View

Johnson S, Evans T, Draper E, Field D, Manktelow B, Marlow N . Neurodevelopmental outcomes following late and moderate prematurity: a population-based cohort study. Arch Dis Child Fetal Neonatal Ed. 2015; 100(4):F301-8. PMC: 4484499. DOI: 10.1136/archdischild-2014-307684. View

Adelson P, Child A, Giles W, Henderson-Smart D . Antenatal hospitalisations in New South Wales, 1995-96. Med J Aust. 1999; 170(5):211-5. DOI: 10.5694/j.1326-5377.1999.tb140319.x. View

Fenton T . A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatr. 2003; 3:13. PMC: 324406. DOI: 10.1186/1471-2431-3-13. View

10.

. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. JAMA. 1995; 273(5):413-8. DOI: 10.1001/jama.1995.03520290065031. View

11.

Melamed N, Klinger G, Tenenbaum-Gavish K, Herscovici T, Linder N, Hod M . Short-term neonatal outcome in low-risk, spontaneous, singleton, late preterm deliveries. Obstet Gynecol. 2009; 114(2 Pt 1):253-260. DOI: 10.1097/AOG.0b013e3181af6931. View

12.

Hosli I, Sperschneider C, Drack G, Zimmermann R, Surbek D, Irion O . Tocolysis for preterm labor: expert opinion. Arch Gynecol Obstet. 2014; 289(4):903-9. DOI: 10.1007/s00404-013-3137-9. View

13.

van Vliet E, Boormans E, de Lange T, Mol B, Oudijk M . Preterm labor: current pharmacotherapy options for tocolysis. Expert Opin Pharmacother. 2014; 15(6):787-97. DOI: 10.1517/14656566.2014.889684. View

14.

Bacak S, Callaghan W, Dietz P, Crouse C . Pregnancy-associated hospitalizations in the United States, 1999-2000. Am J Obstet Gynecol. 2005; 192(2):592-7. DOI: 10.1016/j.ajog.2004.10.638. View

15.

Berkman N, Thorp Jr J, Lohr K, Carey T, Hartmann K, Gavin N . Tocolytic treatment for the management of preterm labor: a review of the evidence. Am J Obstet Gynecol. 2003; 188(6):1648-59. DOI: 10.1067/mob.2003.356. View

16.

King J, Flenady V, Cole S, Thornton S . Cyclo-oxygenase (COX) inhibitors for treating preterm labour. Cochrane Database Syst Rev. 2005; (2):CD001992. DOI: 10.1002/14651858.CD001992.pub2. View

17.

Romero R, Espinoza J, Kusanovic J, Gotsch F, Hassan S, Erez O . The preterm parturition syndrome. BJOG. 2007; 113 Suppl 3:17-42. PMC: 7062298. DOI: 10.1111/j.1471-0528.2006.01120.x. View

18.

Mcintire D, Leveno K . Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008; 111(1):35-41. DOI: 10.1097/01.AOG.0000297311.33046.73. View

19.

. ACOG practice bulletin no. 127: Management of preterm labor. Obstet Gynecol. 2012; 119(6):1308-17. DOI: 10.1097/AOG.0b013e31825af2f0. View

20.

Goldenberg R, Culhane J, Iams J, Romero R . Epidemiology and causes of preterm birth. Lancet. 2008; 371(9606):75-84. PMC: 7134569. DOI: 10.1016/S0140-6736(08)60074-4. View