American journal of perinatology · 2026
Perinatal and Maternal Outcomes by Indication for Delivery in the Second Trimester.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cagino Kristen A, McGee Paula L, Costantine Maged M, Varner Michael W, Tita Alan T N, Longo Monica, Stoll Barbara J, Thorp John M, Reddy Uma M, Grobman William A, Rouse Dwight J, Simhan Hyagriv N, Bailit Jennifer L, Dugoff Lorraine, Saade George R, Sibai Baha M, Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland, United States
Аннотация
OBJECTIVE: Perinatal and maternal morbidity in the setting of preterm birth may differ by delivery indication. We compared perinatal and maternal outcomes of second-trimester (240/7-276/7 weeks of gestation) deliveries indicated for preeclampsia with severe features (PE-SF), with those following preterm premature rupture of membranes (PPROM).
STUDY DESIGN: Secondary analysis of an observational cohort study of singleton and twin preterm deliveries before 35 weeks' gestation at 33 hospitals across the United States. Singletons without congenital anomalies who were delivered due to PE-SF or PPROM from 240/7 to 276/7 weeks of gestation were included. The primary outcome was a composite of perinatal morbidity or death, defined as fetal or neonatal death, severe bronchopulmonary dysplasia (BPD) grade III, intraventricular hemorrhage (IVH) grade III to IV, necrotizing enterocolitis (NEC) stage IIA or greater, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP) stage III to IV, or culture-proven sepsis. Secondary outcomes included components of the primary outcome, small-for-gestational-age (SGA) birth, and a composite of maternal morbidity. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated.
RESULTS: Among the 7,515 in the original cohort, 164 deliveries for PE-SF and 119 deliveries following PPROM were included. Individuals with PE-SF were more likely to have a BMI of ≥30 kg/m2, hypertensive disorder of pregnancy in a prior pregnancy, chronic hypertension, and cesarean birth (p < 0.05) compared with those who delivered following PPROM. Composite perinatal morbidity or death did not differ between groups (aOR = 1.60, 95% CI: 0.89, 2.85, p = 0.11), but fetal death was significantly higher in the PE-SF group (aOR = 6.04, 95% CI: 1.42, 25.71). Neonates delivered for PE-SF were more likely to be SGA (aOR = 13.45, 95% CI: 2.92, 61.94). Composite maternal morbidity did not differ between groups (aOR = 1.18, 95% CI: 0.62, 2.26).
CONCLUSION: Second-trimester preterm birth indicated for PE-SF was associated with a higher rate of fetal death than birth for PPROM. Composite neonatal and maternal morbidity did not differ by indication.
KEY POINTS: · Fetal death occurred more frequently in individuals with PE-SF compared with PPROM in the second trimester.. · Composite perinatal and maternal outcomes were similar between groups.. · Our findings can be used for risk stratification and survival prediction rates..
STUDY DESIGN: Secondary analysis of an observational cohort study of singleton and twin preterm deliveries before 35 weeks' gestation at 33 hospitals across the United States. Singletons without congenital anomalies who were delivered due to PE-SF or PPROM from 240/7 to 276/7 weeks of gestation were included. The primary outcome was a composite of perinatal morbidity or death, defined as fetal or neonatal death, severe bronchopulmonary dysplasia (BPD) grade III, intraventricular hemorrhage (IVH) grade III to IV, necrotizing enterocolitis (NEC) stage IIA or greater, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP) stage III to IV, or culture-proven sepsis. Secondary outcomes included components of the primary outcome, small-for-gestational-age (SGA) birth, and a composite of maternal morbidity. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated.
RESULTS: Among the 7,515 in the original cohort, 164 deliveries for PE-SF and 119 deliveries following PPROM were included. Individuals with PE-SF were more likely to have a BMI of ≥30 kg/m2, hypertensive disorder of pregnancy in a prior pregnancy, chronic hypertension, and cesarean birth (p < 0.05) compared with those who delivered following PPROM. Composite perinatal morbidity or death did not differ between groups (aOR = 1.60, 95% CI: 0.89, 2.85, p = 0.11), but fetal death was significantly higher in the PE-SF group (aOR = 6.04, 95% CI: 1.42, 25.71). Neonates delivered for PE-SF were more likely to be SGA (aOR = 13.45, 95% CI: 2.92, 61.94). Composite maternal morbidity did not differ between groups (aOR = 1.18, 95% CI: 0.62, 2.26).
CONCLUSION: Second-trimester preterm birth indicated for PE-SF was associated with a higher rate of fetal death than birth for PPROM. Composite neonatal and maternal morbidity did not differ by indication.
KEY POINTS: · Fetal death occurred more frequently in individuals with PE-SF compared with PPROM in the second trimester.. · Composite perinatal and maternal outcomes were similar between groups.. · Our findings can be used for risk stratification and survival prediction rates..
Предметные рубрики MeSH
AdultFemaleHumansInfant, NewbornPregnancyBronchopulmonary DysplasiaCerebral Intraventricular HemorrhageCohort StudiesEnterocolitis, NecrotizingGestational AgeInfant, Small for Gestational AgeLeukomalacia, PeriventricularOdds RatioPre-EclampsiaPregnancy OutcomePregnancy Trimester, SecondPremature BirthPremature Rupture of Fetal MembranesRetinopathy of PrematurityUnited StatesTwin Studies as Topic