Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies

Objective: The purpose of this study was to compare the rates of indicated and spontaneous preterm delivery among women with chronic hypertension or pregestational diabetes mellitus with the rates among healthy women. Study Design: This was a secondary analysis of data from healthy women with single...

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Published in:American journal of obstetrics and gynecology 2000-12, Vol.183 (6), p.1520-1524
Main Authors: Sibai, Baha M., Caritis, Steve N., Hauth, John C., MacPherson, Cora, VanDorsten, J.Peter, Klebanoff, Mark, Landon, Mark, Paul, Richard H., Meis, Paul J., Miodovnik, Menachem, Dombrowski, Mitchell P., Thurnau, Gary R., Moawad, Atef H., Roberts, James
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Language:English
Subjects:
Biological and medical sciences
Diseases of mother, fetus and pregnancy
Gynecology. Andrology. Obstetrics
Hypertension
indicated preterm delivery
Medical sciences
pregestational diabetes mellitus
Pregnancy. Fetus. Placenta
spontaneous preterm delivery
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cited_by cdi_FETCH-LOGICAL-c317t-aab0fba46988a00ad77bf0295d9a3aa6d5aa217f6933560158c38d51aa08ad803
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container_issue 6
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container_title American journal of obstetrics and gynecology
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creator Sibai, Baha M.
Caritis, Steve N.
Hauth, John C.
MacPherson, Cora
VanDorsten, J.Peter
Klebanoff, Mark
Landon, Mark
Paul, Richard H.
Meis, Paul J.
Miodovnik, Menachem
Dombrowski, Mitchell P.
Thurnau, Gary R.
Moawad, Atef H.
Roberts, James
description Objective: The purpose of this study was to compare the rates of indicated and spontaneous preterm delivery among women with chronic hypertension or pregestational diabetes mellitus with the rates among healthy women. Study Design: This was a secondary analysis of data from healthy women with singleton gestations enrolled in a prospective observational study for prediction of preterm delivery (control group, n = 2738), women with pregestational diabetes mellitus requiring insulin therapy (n = 461), and women with chronic hypertension (n = 761). The two latter groups were enrolled in a randomized multicenter trial for prevention of preeclampsia. The main outcome measures were rates of preterm delivery, either spontaneous (preterm labor or rupture of membranes) or indicated (for maternal or fetal reasons), and neonatal outcomes. Results: The overall rates of preterm delivery were significantly higher among women with diabetes mellitus (38%) and hypertension (33.1%) than among control women (13.9%). Rates were also significantly higher for delivery at
doi_str_mv 10.1067/mob.2000.107621
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Study Design: This was a secondary analysis of data from healthy women with singleton gestations enrolled in a prospective observational study for prediction of preterm delivery (control group, n = 2738), women with pregestational diabetes mellitus requiring insulin therapy (n = 461), and women with chronic hypertension (n = 761). The two latter groups were enrolled in a randomized multicenter trial for prevention of preeclampsia. The main outcome measures were rates of preterm delivery, either spontaneous (preterm labor or rupture of membranes) or indicated (for maternal or fetal reasons), and neonatal outcomes. Results: The overall rates of preterm delivery were significantly higher among women with diabetes mellitus (38%) and hypertension (33.1%) than among control women (13.9%). Rates were also significantly higher for delivery at &lt;35 weeks’ gestation. Women with diabetes mellitus had significantly higher rates of both indicated preterm delivery (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.0-10.9) and spontaneous preterm delivery (16.1% vs 10.5%; odds ratio, 1.6; 95% confidence interval, 1.2-2.2) than did women in the control group. In addition, they had significantly higher rates of both indicated preterm delivery (odds ratio, 4.8; 95% confidence interval, 3.0-7.5) and spontaneous preterm delivery (odds ratio, 2.1; 95% confidence interval, 1.4-3.0) at &lt;35 weeks’ gestation than did control women. Compared with control women those with chronic hypertension had higher rates of indicated preterm delivery at both &lt;37 weeks’ gestation (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.2-10.6) and at &lt;35 weeks’ gestation (12.1% vs 1.6%; odds ratio, 8.2; 95% confidence interval, 5.7-11.9), but there were no differences in rates of spontaneous preterm delivery. Conclusion: The increased rate of preterm delivery among women with chronic hypertension relative to control women was primarily an increase in indicated preterm delivery, whereas the rates of both spontaneous and indicated preterm delivery were increased among women with pregestational diabetes mellitus. (Am J Obstet Gynecol 2000;183:1520-4.)</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1067/mob.2000.107621</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Biological and medical sciences ; Diseases of mother, fetus and pregnancy ; Gynecology. Andrology. Obstetrics ; Hypertension ; indicated preterm delivery ; Medical sciences ; pregestational diabetes mellitus ; Pregnancy. Fetus. Placenta ; spontaneous preterm delivery</subject><ispartof>American journal of obstetrics and gynecology, 2000-12, Vol.183 (6), p.1520-1524</ispartof><rights>2000 Mosby, Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-aab0fba46988a00ad77bf0295d9a3aa6d5aa217f6933560158c38d51aa08ad803</citedby><cites>FETCH-LOGICAL-c317t-aab0fba46988a00ad77bf0295d9a3aa6d5aa217f6933560158c38d51aa08ad803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=833511$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Sibai, Baha M.</creatorcontrib><creatorcontrib>Caritis, Steve N.</creatorcontrib><creatorcontrib>Hauth, John C.</creatorcontrib><creatorcontrib>MacPherson, Cora</creatorcontrib><creatorcontrib>VanDorsten, J.Peter</creatorcontrib><creatorcontrib>Klebanoff, Mark</creatorcontrib><creatorcontrib>Landon, Mark</creatorcontrib><creatorcontrib>Paul, Richard H.</creatorcontrib><creatorcontrib>Meis, Paul J.</creatorcontrib><creatorcontrib>Miodovnik, Menachem</creatorcontrib><creatorcontrib>Dombrowski, Mitchell P.</creatorcontrib><creatorcontrib>Thurnau, Gary R.</creatorcontrib><creatorcontrib>Moawad, Atef H.</creatorcontrib><creatorcontrib>Roberts, James</creatorcontrib><creatorcontrib>for the National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network</creatorcontrib><title>Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies</title><title>American journal of obstetrics and gynecology</title><description>Objective: The purpose of this study was to compare the rates of indicated and spontaneous preterm delivery among women with chronic hypertension or pregestational diabetes mellitus with the rates among healthy women. Study Design: This was a secondary analysis of data from healthy women with singleton gestations enrolled in a prospective observational study for prediction of preterm delivery (control group, n = 2738), women with pregestational diabetes mellitus requiring insulin therapy (n = 461), and women with chronic hypertension (n = 761). The two latter groups were enrolled in a randomized multicenter trial for prevention of preeclampsia. The main outcome measures were rates of preterm delivery, either spontaneous (preterm labor or rupture of membranes) or indicated (for maternal or fetal reasons), and neonatal outcomes. Results: The overall rates of preterm delivery were significantly higher among women with diabetes mellitus (38%) and hypertension (33.1%) than among control women (13.9%). Rates were also significantly higher for delivery at &lt;35 weeks’ gestation. Women with diabetes mellitus had significantly higher rates of both indicated preterm delivery (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.0-10.9) and spontaneous preterm delivery (16.1% vs 10.5%; odds ratio, 1.6; 95% confidence interval, 1.2-2.2) than did women in the control group. In addition, they had significantly higher rates of both indicated preterm delivery (odds ratio, 4.8; 95% confidence interval, 3.0-7.5) and spontaneous preterm delivery (odds ratio, 2.1; 95% confidence interval, 1.4-3.0) at &lt;35 weeks’ gestation than did control women. Compared with control women those with chronic hypertension had higher rates of indicated preterm delivery at both &lt;37 weeks’ gestation (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.2-10.6) and at &lt;35 weeks’ gestation (12.1% vs 1.6%; odds ratio, 8.2; 95% confidence interval, 5.7-11.9), but there were no differences in rates of spontaneous preterm delivery. Conclusion: The increased rate of preterm delivery among women with chronic hypertension relative to control women was primarily an increase in indicated preterm delivery, whereas the rates of both spontaneous and indicated preterm delivery were increased among women with pregestational diabetes mellitus. (Am J Obstet Gynecol 2000;183:1520-4.)</description><subject>Biological and medical sciences</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hypertension</subject><subject>indicated preterm delivery</subject><subject>Medical sciences</subject><subject>pregestational diabetes mellitus</subject><subject>Pregnancy. Fetus. 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Andrology. Obstetrics</topic><topic>Hypertension</topic><topic>indicated preterm delivery</topic><topic>Medical sciences</topic><topic>pregestational diabetes mellitus</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>spontaneous preterm delivery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sibai, Baha M.</creatorcontrib><creatorcontrib>Caritis, Steve N.</creatorcontrib><creatorcontrib>Hauth, John C.</creatorcontrib><creatorcontrib>MacPherson, Cora</creatorcontrib><creatorcontrib>VanDorsten, J.Peter</creatorcontrib><creatorcontrib>Klebanoff, Mark</creatorcontrib><creatorcontrib>Landon, Mark</creatorcontrib><creatorcontrib>Paul, Richard H.</creatorcontrib><creatorcontrib>Meis, Paul J.</creatorcontrib><creatorcontrib>Miodovnik, Menachem</creatorcontrib><creatorcontrib>Dombrowski, Mitchell P.</creatorcontrib><creatorcontrib>Thurnau, Gary R.</creatorcontrib><creatorcontrib>Moawad, Atef H.</creatorcontrib><creatorcontrib>Roberts, James</creatorcontrib><creatorcontrib>for the National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sibai, Baha M.</au><au>Caritis, Steve N.</au><au>Hauth, John C.</au><au>MacPherson, Cora</au><au>VanDorsten, J.Peter</au><au>Klebanoff, Mark</au><au>Landon, Mark</au><au>Paul, Richard H.</au><au>Meis, Paul J.</au><au>Miodovnik, Menachem</au><au>Dombrowski, Mitchell P.</au><au>Thurnau, Gary R.</au><au>Moawad, Atef H.</au><au>Roberts, James</au><aucorp>for the National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><date>2000-12-01</date><risdate>2000</risdate><volume>183</volume><issue>6</issue><spage>1520</spage><epage>1524</epage><pages>1520-1524</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective: The purpose of this study was to compare the rates of indicated and spontaneous preterm delivery among women with chronic hypertension or pregestational diabetes mellitus with the rates among healthy women. Study Design: This was a secondary analysis of data from healthy women with singleton gestations enrolled in a prospective observational study for prediction of preterm delivery (control group, n = 2738), women with pregestational diabetes mellitus requiring insulin therapy (n = 461), and women with chronic hypertension (n = 761). The two latter groups were enrolled in a randomized multicenter trial for prevention of preeclampsia. The main outcome measures were rates of preterm delivery, either spontaneous (preterm labor or rupture of membranes) or indicated (for maternal or fetal reasons), and neonatal outcomes. Results: The overall rates of preterm delivery were significantly higher among women with diabetes mellitus (38%) and hypertension (33.1%) than among control women (13.9%). Rates were also significantly higher for delivery at &lt;35 weeks’ gestation. Women with diabetes mellitus had significantly higher rates of both indicated preterm delivery (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.0-10.9) and spontaneous preterm delivery (16.1% vs 10.5%; odds ratio, 1.6; 95% confidence interval, 1.2-2.2) than did women in the control group. In addition, they had significantly higher rates of both indicated preterm delivery (odds ratio, 4.8; 95% confidence interval, 3.0-7.5) and spontaneous preterm delivery (odds ratio, 2.1; 95% confidence interval, 1.4-3.0) at &lt;35 weeks’ gestation than did control women. Compared with control women those with chronic hypertension had higher rates of indicated preterm delivery at both &lt;37 weeks’ gestation (21.9% vs 3.4%; odds ratio, 8.1; 95% confidence interval, 6.2-10.6) and at &lt;35 weeks’ gestation (12.1% vs 1.6%; odds ratio, 8.2; 95% confidence interval, 5.7-11.9), but there were no differences in rates of spontaneous preterm delivery. Conclusion: The increased rate of preterm delivery among women with chronic hypertension relative to control women was primarily an increase in indicated preterm delivery, whereas the rates of both spontaneous and indicated preterm delivery were increased among women with pregestational diabetes mellitus. (Am J Obstet Gynecol 2000;183:1520-4.)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><doi>10.1067/mob.2000.107621</doi><tpages>5</tpages></addata></record>
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subjects Biological and medical sciences
Diseases of mother, fetus and pregnancy
Gynecology. Andrology. Obstetrics
Hypertension
indicated preterm delivery
Medical sciences
pregestational diabetes mellitus
Pregnancy. Fetus. Placenta
spontaneous preterm delivery
title Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies
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