Iatrogenic and spontaneous preterm birth in England: A population-based cohort study.


Journal

BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741

Informations de publication

Date de publication:
01 2023
Historique:
revised: 10 08 2022
received: 10 01 2022
accepted: 22 08 2022
pubmed: 9 9 2022
medline: 7 12 2022
entrez: 8 9 2022
Statut: ppublish

Résumé

To describe the rates of and risk factors associated with iatrogenic and spontaneous preterm birth and the variation in rates between hospitals. Cohort study using electronic health records. English National Health Service. Singleton births between 1 April 2015 and 31 March 2017. Multivariable Poisson regression models were used to estimate adjusted risk ratios (adjRR) to measure association with maternal demographic and clinical risk factors. Preterm births (<37 weeks of gestation) were defined as iatrogenic or spontaneous according to mode of onset of labour. Of the births, 6.1% were preterm and of these, 52.8% were iatrogenic. The proportion of preterm births that were iatrogenic increased after 32 weeks. Both sub-groups were associated with previous preterm birth, extremes of maternal age, socio-economic deprivation and smoking. Iatrogenic preterm birth was associated with higher body mass index (BMI) (BMI >40 kg/m Just over half of all preterm births resulted from iatrogenic intervention. Iatrogenic births have overlapping but different patterns of maternal demographic and clinical risk factors to spontaneous preterm births. Iatrogenic and spontaneous sub-groups should therefore be measured and monitored separately, as well as in aggregate, to facilitate different prevention strategies. This is feasible using routinely acquired hospital data.

Identifiants

pubmed: 36073305
doi: 10.1111/1471-0528.17291
pmc: PMC10092353
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

33-41

Subventions

Organisme : Scottish and Welsh Governments
Organisme : NHS England
Organisme : Healthcare Quality Improvement Partnership (HQIP)

Investigateurs

Andrea Blotkamp (A)
Fran Carroll (F)
Megan Coe (M)
George Dunn (G)
Rebecca Geary (R)
Alissa Harvey (A)
Emma Heighway (E)
Asma Khalil (A)
Julia Langham (J)
Lindsey Mamza (L)
Patrick Muller (P)
Natalie Moitt (N)
Sophie Relph (S)
Louise Thomas (L)
Lara Waite (L)
Kirstin Webster (K)

Informations de copyright

© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

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Auteurs

Harriet Aughey (H)

Royal College of Obstetricians and Gynaecologists, London, UK.
University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

Jennifer Jardine (J)

Royal College of Obstetricians and Gynaecologists, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Hannah Knight (H)

Royal College of Obstetricians and Gynaecologists, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Ipek Gurol-Urganci (I)

Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Kate Walker (K)

Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Tina Harris (T)

Royal College of Obstetricians and Gynaecologists, London, UK.
Faculty of Health and Life Sciences, De Montfort University, Leicester, UK.

Jan van der Meulen (J)

Royal College of Obstetricians and Gynaecologists, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Jane Hawdon (J)

Royal College of Obstetricians and Gynaecologists, London, UK.
Royal Free NHS Foundation Trust, London, UK.

Dharmintra Pasupathy (D)

Royal College of Obstetricians and Gynaecologists, London, UK.
Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Royal College of Obstetricians and Gynaecologists, London, UK.

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Classifications MeSH