Pregnancy risk factors for very premature delivery: what role do hypertension, obesity and diabetes play?

Arch Gynecol Obstet. 2013 Jul;288(1):57-64. doi: 10.1007/s00404-013-2739-6. Epub 2013 Feb 12.

Abstract

Purpose: Very premature delivery is a major cause of infant morbidity and mortality. Obesity, diabetes and pregnancy hypertension are known risk factors for pregnancy complications. The study aimed to scrutinize differences of pregnancy complications in a cohort of very premature deliveries compared to a national group.

Methods: In a multicenter study performed between January 2009 and December 2010 including 1,577 very low birth weight (VLBW) infants, we compared parental reported pregnancy problems of VLBW infants with a national cohort (KIGGS). We compared reported pregnancy complications to reasons for premature delivery and neonatal outcome within the group of VLBW infants.

Results: While parents of the national cohort reported pregnancy-induced hypertension in 8 %, parents of VLBW infants reported this complication more frequently (27 %). Mothers of the national cohort were significantly younger (1 year), suffered less from obesity, anaemia, diabetes. Regression analysis showed that hypertension (OR = 5.11) and advanced maternal age (OR = 1.03) increased the risk for premature birth. Women with hypertension were likely to experience a clinically indicated premature delivery, had more VLBW infants with a moderate growth restriction, but less multiples and their infants had less intraventricular haemorrhages grade 3 or 4. Otherwise, neonatal outcome was correlated with gestational age but not with the pregnancy complications diabetes, hypertension or obesity.

Conclusion: Premature birth seems to be correlated to gestational hypertension and associated problems in about ¼ of VLBW infants. Further studies should focus on preventing and treating gestational hypertension to avoid premature delivery and associated neonatal morbidity.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Diabetes Mellitus / epidemiology*
  • Female
  • Germany / epidemiology
  • Gestational Age
  • Humans
  • Hypertension / epidemiology*
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Obesity / epidemiology*
  • Odds Ratio
  • Pregnancy
  • Premature Birth / epidemiology*
  • Regression Analysis
  • Risk Factors