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

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Acknowledgments

This study is part of a larger project (German neonatal network, GNN) and is funded by the German Ministry for Education and Research (BMBF-Grant-no. 01ER0805).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Lübeck, Ratzeburger Allee 160, 23538, Lüebeck, Germany

    Juliane Spiegler, G. Stichtenoth, E. Herting & W. Göpel

  2. Department of Gynecology and Obstetrics, University of Lübeck, Ratzeburger Allee 160, 23538, Lüebeck, Germany

    J. Weichert

  3. Institute of Medical Biometry and Statistics, University of Lübeck, Maria-Goeppert-Str. 1, 23562, Lübeck, Germany

    I. R. König

  4. Robert-Koch-Institut, Nordufer 20, 13353, Berlin, Germany

    M. Schlaud

  5. Department of Neonatology, Altonaer Kinderkrankenhaus, Paul-Ehrlich-Str. 1, 22763, Hamburg, Germany

    A. v.d. Wense

  6. Department of Neonatology, Klinikum Südstadt, Südring 81, 19059, Rostock, Germany

    D. Olbertz

  7. Department of Neonatology and Pediatric Intensive Care, Carl Gustav Carus University, Fetscherstrasse 74, 01307, Dresden, Germany

    H. Gurth

  8. Department of Pediatrics, Klinikum Nürnberg Süd, Breslauer Straße 201, 90471, Nürnberg, Germany

    J.-H. Schiffmann

  9. Department of Pediatrics I, Medizinische Hochschule Hannover, Carl Neuberg Straße 1, 30625, Hannover, Germany

    B. Bohnhorst

  10. Department of Pediatrics, University Hospital of Saarland, 66421, Homburg, Germany

    L. Gortner

Authors
  1. Juliane Spiegler
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  2. G. Stichtenoth
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  3. J. Weichert
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  4. I. R. König
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  5. M. Schlaud
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  6. A. v.d. Wense
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  7. D. Olbertz
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  8. H. Gurth
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  9. J.-H. Schiffmann
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  10. B. Bohnhorst
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  11. L. Gortner
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  12. E. Herting
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  13. W. Göpel
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Consortia

The German Neonatal Network, GNN

Corresponding author

Correspondence to Juliane Spiegler.

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Spiegler, J., Stichtenoth, G., Weichert, J. et al. Pregnancy risk factors for very premature delivery: what role do hypertension, obesity and diabetes play?. Arch Gynecol Obstet 288, 57–64 (2013). https://doi.org/10.1007/s00404-013-2739-6

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  • DOI: https://doi.org/10.1007/s00404-013-2739-6

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