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Journal ArticleDOI

Epidemiology and causes of preterm birth

TL;DR: A short cervical length and a raised cervical-vaginal fetal fibronectin concentration are the strongest predictors of spontaneous preterm birth.
About: This article is published in The Lancet.The article was published on 2008-01-05 and is currently open access. It has received 6275 citations till now. The article focuses on the topics: Extreme Preterm Birth & Fetal fibronectin.
Citations
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Journal ArticleDOI
TL;DR: Worldwide, regional, and national estimates of preterm birth rates for 184 countries in 2010 with time trends for selected countries are reported, and a quantitative assessment of the uncertainty surrounding these estimates is provided.

3,742 citations

Journal ArticleDOI
TL;DR: Because mortality rates have fallen, the focus for perinatal interventions is to develop strategies to reduce long-term morbidity, especially the prevention of brain injury and abnormal brain development.

2,431 citations

Journal ArticleDOI
23 Sep 2011-Thyroid
TL;DR: The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy and thyrotoxicosis in pregnancy.
Abstract: Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2...

2,409 citations


Cites background from "Epidemiology and causes of preterm ..."

  • ...Preterm birth has remained difficult to predict, prevent, and treat primarily because there are multiple potential causes and pathways that end in premature labor (186)....

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Journal ArticleDOI
Lelia Duley1
TL;DR: Although it is a low cost effective treatment, magnesium sulfate is not available in all low and middle income countries; scaling up its use for eClampsia and severe preeclampsia will contribute to achieving the Millennium Development Goals.

2,152 citations

Journal ArticleDOI
TL;DR: Developing countries, especially those in Africa and southern Asia, incur the highest burden in terms of absolute numbers, although a high rate is also observed in North America.
Abstract: Resumen Incidencia mundial de parto prematuro: revision sistematica de la morbilidad y mortalidad maternas Objetivo Analizar las tasas de prematuridad a nivel mundial para evaluar la incidencia de este problema de salud publica, determinar la distribucion regional de los partos prematuros y profundizar en el conocimiento de las actuales estrategias de evaluacion.Metodos Los datos utilizados sobre las tasas de prematuridad a nivel mundial se extrajeron a lo largo de una revision sistematica anterior de datos publicados e ineditos sobre la mortalidad y morbilidad maternas notificados entre 1997 y 2002. Esos datos se complementaron mediante una busqueda que abarco el periodo 2003–2007. Las tasas de prematuridad de los paises sin datos se estimaron mediante modelos de regresion multiple especificos para cada region.Resultados Estimamos que en 2005 se registraron 12,9 millones de partos prematuros, lo que representa el 9,6% de todos los nacimientos a nivel mundial. Aproximadamente 11 millones (85%) de ellos se concentraron en Africa y Asia, mientras que en Europa y America del Norte (excluido Mexico) se registraron 0,5 millones en cada caso, y en America Latina y el Caribe, 0,9 millones. Las tasas mas elevadas de prematuridad se dieron en Africa y America del Norte (11,9% y 10,6% de todos los nacimientos, respectivamente), y las mas bajas en Europa (6,2%).Conclusion El parto prematuro es un problema de salud perinatal importante en todo el mundo. Los paises en desarrollo, especialmente de Africa y Asia meridional, son los que sufren la carga mas alta en terminos absolutos, pero en America del Norte tambien se observa una tasa elevada. Es necesario comprender mejor las causas de la prematuridad y obtener estimaciones mas precisas de la incidencia de ese problema en cada pais si se desea mejorar el acceso a una atencion obstetrica y neonatal eficaz.

1,829 citations

References
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Journal ArticleDOI
TL;DR: The standardized score facilitates future research concerning bacterial vaginosis because it provides gradations of the disturbance of vaginal flora which may be associated with different levels of risk for pregnancy complications.
Abstract: The purpose of the study was to examine intercenter variability in the interpretation of Gram-stained vaginal smears from pregnant women. The intercenter reliability of individual morphotypes identified on the vaginal smear was evaluated by comparing them with those obtained at a standard center. A new scoring system that uses the most reliable morphotypes from the vaginal smear was proposed for diagnosing bacterial vaginosis. This scoring system was compared with the Spiegel criteria for diagnosing bacterial vaginosis. The scoring system (0 to 10) was described as a weighted combination of the following morphotypes: lactobacilli, Gardnerella vaginalis or bacteroides (small gram-variable rods or gram-negative rods), and curved gram-variable rods. By using the Spearman rank correlation to determine intercenter variability, gram-positive cocci had poor agreement (0.23); lactobacilli (0.65), G. vaginalis (0.69), and bacteroides (0.57) had moderate agreement; and small (0.74) and curved (0.85) gram-variable rods had good agreement. The reliability of the 0 to 10 scoring system was maximized by not using gram-positive cocci, combining G. vaginalis and bacteroides morphotypes, and weighting more heavily curved gram-variable rods. For comparison with the Spiegel criteria, a score of 7 or higher was considered indicative of bacterial vaginosis. The standardized score had improved intercenter reliability (r = 0.82) compared with the Spiegel criteria (r = 0.61). The standardized score also facilitates future research concerning bacterial vaginosis because it provides gradations of the disturbance of vaginal flora which may be associated with different levels of risk for pregnancy complications. Images

2,981 citations


"Epidemiology and causes of preterm ..." refers methods in this paper

  • ...96 A score of 7-10 is used to diagnose bacterial vaginosis, and has been associated with a 1·5-fold to 3-fold increase in the rate of preterm birth....

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Journal ArticleDOI
TL;DR: To better delineate periods of peak prevalence and incidence for perinatal depression and identify high risk subpopulations, studies with larger and more representative samples are needed.

2,797 citations


"Epidemiology and causes of preterm ..." refers result in this paper

  • ...52, 53 Although the results are inconsistent, several reports suggest a relation (risks generally rose <2-fold) between depression and preterm birth....

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Journal ArticleDOI
TL;DR: Because mortality rates have fallen, the focus for perinatal interventions is to develop strategies to reduce long-term morbidity, especially the prevention of brain injury and abnormal brain development.

2,431 citations


"Epidemiology and causes of preterm ..." refers background in this paper

  • ...6 Here, we explore the epidemiology, causes, and mechanisms leading to preterm births....

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Journal ArticleDOI
TL;DR: Preterm delivery is the chief problem in obstetrics today, accounting for 70 percent of perinatal mortality and nearly half of long-term neurologic morbidity, and the remainder follow the spontaneous onset of labor or rupture.
Abstract: Preterm delivery is the chief problem in obstetrics today, accounting for 70 percent of perinatal mortality and nearly half of long-term neurologic morbidity.1,2 Approximately 10 percent of all births are preterm, but most of the serious illness and death is concentrated in the 1 to 2 percent of infants who are born at less than 32 weeks of gestation and who weigh less than 1500 g. Approximately 20 percent of preterm births are the result of a physician's decision to bring about delivery for maternal or fetal indications, and the remainder follow the spontaneous onset of labor or rupture . . .

2,331 citations


"Epidemiology and causes of preterm ..." refers background in this paper

  • ...66, 67 The mechanisms by which intrauterine infections lead to preterm labour are related to activation of the innate immune system....

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  • ...67, 86 The most common pathway is the ascending route....

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  • ...67 Fluorescence in-situ hybridisation with a DNA probe specifi c for conserved regions of bacterial DNA (the 16S ribosomal RNA) has detected bacteria in the membranes of up to 70% of women undergoing elective caesarean section at term....

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  • ...67, 84 The genital mycoplasmas and other organisms detected in the uterus before membrane rupture are typically of low virulence, probably accounting for both the chronicity of intrauterine infections and the frequent absence of overt clinical signs of infection....

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  • ...67 Women with positive U urealyticum amniotic fl uid cultures or who are PCR-positive for U urealyticum at the time of midtrimester genetic amniocentesis often have spontaneous preterm labour or PPROM weeks after the procedure....

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Journal ArticleDOI
TL;DR: Application of practical diagnostic criteria for standard clinical use should assist in clinical management of nonspecific vaginitis and in further study of the microbiologic and biochemical correlates and the pathogenesis of this mild but quite prevalent disease.

2,273 citations