Are women with recurrent spontaneous preterm births different from those without such history?

Brian M. Mercer, Cora A. Macpherson, Robert L. Goldenberg, Alice R. Goepfert, Sylvie Haugel-De Mouzon, Michael W. Varner, Jay D. Iams, Paul J. Meis, Atef H. Moawad, Menachem Miodovnik, Steve N. Caritis, J. Peter Van Dorsten, Yoram Sorokin, Gary R. Thurnau, Catherine Y. Spong

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: This study was undertaken to determine whether women with recurrent spontaneous preterm births (rSPBs) have different clinical characteristics or systemic markers than those with isolated preterm (iSPBs) or recurrent term births (rTBs), when assessed remote from delivery. Study design: We compared clinical characteristics and findings (including cervical ultrasound, bacterial vaginosis, fetal fibronectin), maternal plasma markers obtained at 22 to 24 weeks' gestation (inflammatory cytokines, cortisol, and corticotrophin-releasing hormone), between women with rSPBs (2 or 3 consecutive SPBs and no TBs), iSPBs (1 SPB and 1 or 2 TBs), and rTBs (2 or 3 consecutive TBs and no SPBs). Results: A total of 1257 women met our inclusion criteria; 47 rSPBs, 241 iSPBs (80 current and 161 prior iSPBs), and 969 rTBs. Before pregnancy, women with rSPBs had lower weights (P < .0001) and body mass indexes (BMIs) (P < .001), and were more likely to be less than 100 lbs (P = .008) or less than 19.8 kg/m2 BMI (P = .001). At 22 to 24 weeks those with rSPBs remained lighter and leaner, and had more advanced Bishop scores than iSPBs and rTBs. Ultrasound demonstrated progressive decrease in cervical length for those with rTBs, prior iSPBs, current iSPBs, and rSPBs, and also progressively more frequent short cervixes with worsening history (P < .001). Cervical length was shorter for women of lower pregravid weight and BMI, but not with shorter height. At 22 to 24 weeks, women with rSPBs had more common uterine contractions and tocolytic agents, but not more infections or antibiotic therapy. Those with an SPB in the current gestation had higher fetal fibronectin levels and more frequent vaginal bleeding, regardless of prior outcome. Maternal cortisol and corticotrophin-releasing hormone were higher in women with iSPBs and rSPBs than in rTB controls, (P = .001 and .0027), a finding more apparent with SPB in the current pregnancy. However, maternal cytokines were not increased with either iSPBs or rSPBs. Conclusion: Women with rSPBs are leaner, contract more, have shorter cervixes, and have more advanced Bishop scores than women with iSPBs or rTBs.

Original languageEnglish (US)
Pages (from-to)1176-1184
Number of pages9
JournalAmerican journal of obstetrics and gynecology
Volume194
Issue number4
DOIs
StatePublished - Apr 1 2006
Externally publishedYes

Fingerprint

Premature Birth
Term Birth
History
Pregnancy
Body Mass Index
Corticotropin-Releasing Hormone
Mothers
Fibronectins
Cervix Uteri
Hydrocortisone
Tocolytic Agents
Cytokines
Bacterial Vaginosis
Weights and Measures
Uterine Contraction
Uterine Hemorrhage
Anti-Bacterial Agents

Keywords

  • Prediction
  • Preterm birth
  • Recurrence
  • Risk factors

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Mercer, B. M., Macpherson, C. A., Goldenberg, R. L., Goepfert, A. R., Haugel-De Mouzon, S., Varner, M. W., ... Spong, C. Y. (2006). Are women with recurrent spontaneous preterm births different from those without such history? American journal of obstetrics and gynecology, 194(4), 1176-1184. https://doi.org/10.1016/j.ajog.2006.01.069

Are women with recurrent spontaneous preterm births different from those without such history? / Mercer, Brian M.; Macpherson, Cora A.; Goldenberg, Robert L.; Goepfert, Alice R.; Haugel-De Mouzon, Sylvie; Varner, Michael W.; Iams, Jay D.; Meis, Paul J.; Moawad, Atef H.; Miodovnik, Menachem; Caritis, Steve N.; Van Dorsten, J. Peter; Sorokin, Yoram; Thurnau, Gary R.; Spong, Catherine Y.

In: American journal of obstetrics and gynecology, Vol. 194, No. 4, 01.04.2006, p. 1176-1184.

Research output: Contribution to journalArticle

Mercer, BM, Macpherson, CA, Goldenberg, RL, Goepfert, AR, Haugel-De Mouzon, S, Varner, MW, Iams, JD, Meis, PJ, Moawad, AH, Miodovnik, M, Caritis, SN, Van Dorsten, JP, Sorokin, Y, Thurnau, GR & Spong, CY 2006, 'Are women with recurrent spontaneous preterm births different from those without such history?', American journal of obstetrics and gynecology, vol. 194, no. 4, pp. 1176-1184. https://doi.org/10.1016/j.ajog.2006.01.069
Mercer BM, Macpherson CA, Goldenberg RL, Goepfert AR, Haugel-De Mouzon S, Varner MW et al. Are women with recurrent spontaneous preterm births different from those without such history? American journal of obstetrics and gynecology. 2006 Apr 1;194(4):1176-1184. https://doi.org/10.1016/j.ajog.2006.01.069
Mercer, Brian M. ; Macpherson, Cora A. ; Goldenberg, Robert L. ; Goepfert, Alice R. ; Haugel-De Mouzon, Sylvie ; Varner, Michael W. ; Iams, Jay D. ; Meis, Paul J. ; Moawad, Atef H. ; Miodovnik, Menachem ; Caritis, Steve N. ; Van Dorsten, J. Peter ; Sorokin, Yoram ; Thurnau, Gary R. ; Spong, Catherine Y. / Are women with recurrent spontaneous preterm births different from those without such history?. In: American journal of obstetrics and gynecology. 2006 ; Vol. 194, No. 4. pp. 1176-1184.
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T1 - Are women with recurrent spontaneous preterm births different from those without such history?

AU - Mercer, Brian M.

AU - Macpherson, Cora A.

AU - Goldenberg, Robert L.

AU - Goepfert, Alice R.

AU - Haugel-De Mouzon, Sylvie

AU - Varner, Michael W.

AU - Iams, Jay D.

AU - Meis, Paul J.

AU - Moawad, Atef H.

AU - Miodovnik, Menachem

AU - Caritis, Steve N.

AU - Van Dorsten, J. Peter

AU - Sorokin, Yoram

AU - Thurnau, Gary R.

AU - Spong, Catherine Y.

PY - 2006/4/1

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N2 - Objective: This study was undertaken to determine whether women with recurrent spontaneous preterm births (rSPBs) have different clinical characteristics or systemic markers than those with isolated preterm (iSPBs) or recurrent term births (rTBs), when assessed remote from delivery. Study design: We compared clinical characteristics and findings (including cervical ultrasound, bacterial vaginosis, fetal fibronectin), maternal plasma markers obtained at 22 to 24 weeks' gestation (inflammatory cytokines, cortisol, and corticotrophin-releasing hormone), between women with rSPBs (2 or 3 consecutive SPBs and no TBs), iSPBs (1 SPB and 1 or 2 TBs), and rTBs (2 or 3 consecutive TBs and no SPBs). Results: A total of 1257 women met our inclusion criteria; 47 rSPBs, 241 iSPBs (80 current and 161 prior iSPBs), and 969 rTBs. Before pregnancy, women with rSPBs had lower weights (P < .0001) and body mass indexes (BMIs) (P < .001), and were more likely to be less than 100 lbs (P = .008) or less than 19.8 kg/m2 BMI (P = .001). At 22 to 24 weeks those with rSPBs remained lighter and leaner, and had more advanced Bishop scores than iSPBs and rTBs. Ultrasound demonstrated progressive decrease in cervical length for those with rTBs, prior iSPBs, current iSPBs, and rSPBs, and also progressively more frequent short cervixes with worsening history (P < .001). Cervical length was shorter for women of lower pregravid weight and BMI, but not with shorter height. At 22 to 24 weeks, women with rSPBs had more common uterine contractions and tocolytic agents, but not more infections or antibiotic therapy. Those with an SPB in the current gestation had higher fetal fibronectin levels and more frequent vaginal bleeding, regardless of prior outcome. Maternal cortisol and corticotrophin-releasing hormone were higher in women with iSPBs and rSPBs than in rTB controls, (P = .001 and .0027), a finding more apparent with SPB in the current pregnancy. However, maternal cytokines were not increased with either iSPBs or rSPBs. Conclusion: Women with rSPBs are leaner, contract more, have shorter cervixes, and have more advanced Bishop scores than women with iSPBs or rTBs.

AB - Objective: This study was undertaken to determine whether women with recurrent spontaneous preterm births (rSPBs) have different clinical characteristics or systemic markers than those with isolated preterm (iSPBs) or recurrent term births (rTBs), when assessed remote from delivery. Study design: We compared clinical characteristics and findings (including cervical ultrasound, bacterial vaginosis, fetal fibronectin), maternal plasma markers obtained at 22 to 24 weeks' gestation (inflammatory cytokines, cortisol, and corticotrophin-releasing hormone), between women with rSPBs (2 or 3 consecutive SPBs and no TBs), iSPBs (1 SPB and 1 or 2 TBs), and rTBs (2 or 3 consecutive TBs and no SPBs). Results: A total of 1257 women met our inclusion criteria; 47 rSPBs, 241 iSPBs (80 current and 161 prior iSPBs), and 969 rTBs. Before pregnancy, women with rSPBs had lower weights (P < .0001) and body mass indexes (BMIs) (P < .001), and were more likely to be less than 100 lbs (P = .008) or less than 19.8 kg/m2 BMI (P = .001). At 22 to 24 weeks those with rSPBs remained lighter and leaner, and had more advanced Bishop scores than iSPBs and rTBs. Ultrasound demonstrated progressive decrease in cervical length for those with rTBs, prior iSPBs, current iSPBs, and rSPBs, and also progressively more frequent short cervixes with worsening history (P < .001). Cervical length was shorter for women of lower pregravid weight and BMI, but not with shorter height. At 22 to 24 weeks, women with rSPBs had more common uterine contractions and tocolytic agents, but not more infections or antibiotic therapy. Those with an SPB in the current gestation had higher fetal fibronectin levels and more frequent vaginal bleeding, regardless of prior outcome. Maternal cortisol and corticotrophin-releasing hormone were higher in women with iSPBs and rSPBs than in rTB controls, (P = .001 and .0027), a finding more apparent with SPB in the current pregnancy. However, maternal cytokines were not increased with either iSPBs or rSPBs. Conclusion: Women with rSPBs are leaner, contract more, have shorter cervixes, and have more advanced Bishop scores than women with iSPBs or rTBs.

KW - Prediction

KW - Preterm birth

KW - Recurrence

KW - Risk factors

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