Maternal and Child Health Journal

, Volume 7, Issue 1, pp 53–58

History of Fetal Loss and Other Adverse Pregnancy Outcomes in Relation to Subsequent Risk of Preterm Delivery

  • Amira Y. El-Bastawissi
  • Tanya K. Sorensen
  • Clarisse K. Akafomo
  • Ihunnaya O. Frederick
  • Rong Xiao
  • Michelle A. Williams
Article

Abstract

Objective: To evaluate the association between maternal reproductive history and preterm delivery. Methods: The 312 preterm delivery cases, studied in aggregate, and in subgroups (spontaneous preterm labor, preterm premature rupture of membranes, medically induced preterm delivery, moderate preterm delivery [gestational age at delivery 34–36 weeks], and very preterm delivery [gestational age at delivery <34 weeks]), were compared with 424 randomly selected women who delivered at term. Maternal medical records provided information on maternal reproductive history, pregnancy outcome, as well as sociodemographic characteristics. Using multivariate logistic regression, we derived maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: A history of 2+ miscarriages was ( OR = 2.2; 95% CI 1.2–3.9), but a history of 2+ prior induced abortions (OR = 1.2; 95% CI 0.7–2.0) was not, associated with preterm delivery in the index pregnancy. Analyses of preterm delivery subgroups indicated that a history of 2+ miscarriages was associated with an increasedrisk of spontaneous preterm labor (OR = 2.6; 95% CI 1.2–2.8), preterm premature rupture of membrane (OR = 1.8; 95% 0.7–4.4), and medically induced preterm delivery (OR = 1.9; 95% CI 0.8–4.2), though only the former approached statistical significance. Excess risk of preterm delivery was associated with maternal prior history of delivering a stillborn infant (OR = 10.7), a prior history of delivering a newborn that later died during the neonatal period (OR = 3.2), and a prior history of having a pregnancy complicated by spontaneous preterm delivery (OR = 6.0). Generally these associations were evident for each subgroup of preterm delivery, though inferences were often hindered by our relatively small sample size. Conclusions: These results support the hypothesis that maternal adverse reproductive history is associated with an increased risk of preterm labor and delivery.

preterm delivery reproductive history miscarriage fetal loss 

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References

  1. 1.
    Berkowitz GS. An epidemiologic study of preterm delivery. Am J Epidemiol 1981;113:81–92.Google Scholar
  2. 2.
    Pickering RM, Deeks JJ. Risks of delivery during the 20th to the 36th week of gestation. Int J Epidemiol 1991;20:456–66.Google Scholar
  3. 3.
    Thom DH, Nelson LM, Vaughan TL. Spontaneous abortion and subsequent adverse birth outcomes. Am J Obstet Gynecol 1992;166:111–6.Google Scholar
  4. 4.
    Lang JM, Lieberman E, Cohen A. A comparison of risk factors for preterm labor and term small-for-gestational-age birth. Epidemiology 1996;7:369–76.Google Scholar
  5. 5.
    Hogue CJ, Cates W, Tietze C. The effects of induced abortion on subsequent reproduction. Epidemiol Rev 1982;4:66–94.Google Scholar
  6. 6.
    Bracken MB, Hellenbrand KG, Holford TR, Bryce-Buchanan C. Low birth weight in pregnancies following induced abortion: No evidence for an association. Am J Epidemiol 1986;123:604–13.Google Scholar
  7. 7.
    Mandelson MT, Maden CB, Daling JR. Low birth weight in relation to multiple induced abortions. Am J Public Health 1992;82:391–4.Google Scholar
  8. 8.
    Frank PI, Kay CR, Lewis TL, Parish S. Outcome of pregnancy following induced abortion. Report from the joint study of the Royal College of General Practitioners and the RoyalCollege of Obstetricians and Gynaecologists. Br J Obstet Gynaecol 1985;92:308–16.Google Scholar
  9. 9.
    Savitz DA, Blackmore CA, Thorp JM. Epidemiologic characteristics of preterm delivery: Etiologic heterogeneity. Am J Obstet Gynecol 1991;164:467–71.Google Scholar
  10. 10.
    Williams MA, Mittendorf R, Stubblefield PG, Lieberman E, Schoenbaum SC, Monson RR. Cigarettes, coffee and preterm premature rupture of the membranes. Am J Epidemiol 1992;135:895–905.Google Scholar
  11. 11.
    Obel E. Pregnancy complications following legally induced abortion with special reference to abortion technique. Acta Obstet Gynecol Scand 1979;58:147–52.Google Scholar
  12. 12.
    Meirik O, Bergstrom R. Outcome of delivery subsequent to vacuum-aspiration abortion in nulliparous women. Acta Obstet Gynecol Scand 1983;62:499–509.Google Scholar
  13. 13.
    Keirse MJ, Rush RW, Anderson AB, Turnbull AC. Risk of pre-term delivery in patients with previous pre-term delivery and/or abortion. Br J Obstet Gynaecol 1978;85:81–5.Google Scholar
  14. 14.
    Watts DH, Krohn MA, Hillier SL, Eschenbach DA. The association of occult amniotic fluid infection with gestational age and neonatal outcome among women in preterm labor. Obstet Gynecol 1992;79:351–7.Google Scholar
  15. 15.
    Wenstrom KD, Andrews WW, Hauth JC, Goldenberg RL, Dubard MB, Cliver SP. Elevated second-trimester amniotic fluid interleukin-6 levels predict preterm delivery. Am J Obstet Gynecol 1998;178:546–50.Google Scholar
  16. 16.
    Stray-Pedersen B, Eng J, Reikvam TM. Uterine T-mycoplasma colonization in reproductive failure. Am J Obstet Gynecol 1978;130:307–11.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Amira Y. El-Bastawissi
    • 1
  • Tanya K. Sorensen
    • 1
  • Clarisse K. Akafomo
    • 1
  • Ihunnaya O. Frederick
    • 1
  • Rong Xiao
    • 1
  • Michelle A. Williams
    • 1
    • 2
  1. 1.Center for Perinatal StudiesSwedish Medical CenterSeattle
  2. 2.Department of EpidemiologyUniversity of Washington School of Public Health and Community MedicineSeattle

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