Archives of Gynecology and Obstetrics

, Volume 288, Issue 1, pp 57–64

Pregnancy risk factors for very premature delivery: what role do hypertension, obesity and diabetes play?

  • Juliane Spiegler
  • G. Stichtenoth
  • J. Weichert
  • I. R. König
  • M. Schlaud
  • A. v.d. Wense
  • D. Olbertz
  • H. Gurth
  • J.-H. Schiffmann
  • B. Bohnhorst
  • L. Gortner
  • E. Herting
  • W. Göpel
  • The German Neonatal Network, GNN
Maternal-Fetal Medicine

DOI: 10.1007/s00404-013-2739-6

Cite this article as:
Spiegler, J., Stichtenoth, G., Weichert, J. et al. Arch Gynecol Obstet (2013) 288: 57. doi:10.1007/s00404-013-2739-6

Abstract

Purpose

Very premature delivery is a major cause of infant morbidity and mortality. Obesity, diabetes and pregnancy hypertension are known risk factors for pregnancy complications. The study aimed to scrutinize differences of pregnancy complications in a cohort of very premature deliveries compared to a national group.

Methods

In a multicenter study performed between January 2009 and December 2010 including 1,577 very low birth weight (VLBW) infants, we compared parental reported pregnancy problems of VLBW infants with a national cohort (KIGGS). We compared reported pregnancy complications to reasons for premature delivery and neonatal outcome within the group of VLBW infants.

Results

While parents of the national cohort reported pregnancy-induced hypertension in 8 %, parents of VLBW infants reported this complication more frequently (27 %). Mothers of the national cohort were significantly younger (1 year), suffered less from obesity, anaemia, diabetes. Regression analysis showed that hypertension (OR = 5.11) and advanced maternal age (OR = 1.03) increased the risk for premature birth. Women with hypertension were likely to experience a clinically indicated premature delivery, had more VLBW infants with a moderate growth restriction, but less multiples and their infants had less intraventricular haemorrhages grade 3 or 4. Otherwise, neonatal outcome was correlated with gestational age but not with the pregnancy complications diabetes, hypertension or obesity.

Conclusion

Premature birth seems to be correlated to gestational hypertension and associated problems in about ¼ of VLBW infants. Further studies should focus on preventing and treating gestational hypertension to avoid premature delivery and associated neonatal morbidity.

Keywords

VLBWHypertensionObesityDiabetesOutcomePremature delivery

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Juliane Spiegler
    • 1
  • G. Stichtenoth
    • 1
  • J. Weichert
    • 2
  • I. R. König
    • 3
  • M. Schlaud
    • 4
  • A. v.d. Wense
    • 5
  • D. Olbertz
    • 6
  • H. Gurth
    • 7
  • J.-H. Schiffmann
    • 8
  • B. Bohnhorst
    • 9
  • L. Gortner
    • 10
  • E. Herting
    • 1
  • W. Göpel
    • 1
  • The German Neonatal Network, GNN
  1. 1.Department of PediatricsUniversity of LübeckLüebeckGermany
  2. 2.Department of Gynecology and ObstetricsUniversity of LübeckLüebeckGermany
  3. 3.Institute of Medical Biometry and StatisticsUniversity of LübeckLübeckGermany
  4. 4.Robert-Koch-InstitutBerlinGermany
  5. 5.Department of NeonatologyAltonaer KinderkrankenhausHamburgGermany
  6. 6.Department of NeonatologyKlinikum SüdstadtRostockGermany
  7. 7.Department of Neonatology and Pediatric Intensive CareCarl Gustav Carus UniversityDresdenGermany
  8. 8.Department of PediatricsKlinikum Nürnberg SüdNürnbergGermany
  9. 9.Department of Pediatrics IMedizinische Hochschule HannoverHannoverGermany
  10. 10.Department of PediatricsUniversity Hospital of SaarlandHomburgGermany