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Prediction and Prevention of Preterm Birth: Now and Future

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 18296

Special Issue Editors

Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
Interests: pregnancy; preterm birth; childbirth; fetal diseases; pelvic floor disorders; postpartum hemorrhage; abortion; stillbirth; pregnancy hypertension; gestational diabetes; placenta
Special Issues, Collections and Topics in MDPI journals
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
Interests: preterm labor; preterm premature rupture of membranes; cervical insufficiency; preeclampsia; gestational diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The World Health Organization recently announced that urgent action is needed to deal with the about 15 million babies which are born too soon each year, especially as the preterm birth rate increases every year. This is absolutely essential, especially if we wish to meet the Millennium Development Goals for Child Survival since 2015, as 40% of deaths under 5 today occur in newborns, and if we want to provide added value for maternal health investment as well. For surviving babies, the risk of disability increases, putting strain on families and healthcare systems.

The best outcome can be drawn from the prediction and prevention of disease. Preterm birth is a multifactorial condition, and therefore, this will be solved through various studies on clinical, biological, and sociobehavioral aspects. For the last several decades, growing evidence has been identified regarding the causes of preterm birth; however, the pathogenesis still remains to be fully elucidated. This is the right time for multifaceted stakeholders, including pregnant women, healthcare providers, policy makers, opinion leaders, and industrial personnel, to discuss this difficult subject together. The scientific approach to solve preterm birth can be performed using various research tools, such as observational, experimental (clinical or basic), and translational designs, meta-analyses, and convergence innovation methods. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the present status and future of prediction and prevention in preterm birth. Original research and review papers regarding these topics will be accepted for this Special Issue, especially those combining multiple aspects of preterm birth.

Dr. Ki Hoon Ahn
Dr. JoonHo Lee
Guest Editors

Manuscript Submission Information

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Keywords

  • preterm birth
  • prediction
  • prevention
  • early diagnosis
  • perinatal outcomes
  • long-term impact
  • socioeconomic effect
  • pathogenesis

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Published Papers (6 papers)

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Research

11 pages, 772 KiB  
Article
Association of Preterm Birth with Inflammatory Bowel Disease and Salivary Gland Disease: Machine Learning Analysis Using National Health Insurance Data
Int. J. Environ. Res. Public Health 2022, 19(5), 3056; https://doi.org/10.3390/ijerph19053056 - 05 Mar 2022
Cited by 3 | Viewed by 1759
Abstract
This study employs machine learning and population data for testing the associations of preterm birth with inflammatory bowel disease (IBD), salivary gland disease, socioeconomic status and medication history, including proton pump inhibitors. The source of population-based retrospective cohort data was the Korea National [...] Read more.
This study employs machine learning and population data for testing the associations of preterm birth with inflammatory bowel disease (IBD), salivary gland disease, socioeconomic status and medication history, including proton pump inhibitors. The source of population-based retrospective cohort data was the Korea National Health Insurance Service claims data for all women aged 25–40 years and who experience their first childbirths as singleton pregnancy during 2015 to 2017 (402,092 women). These participants were divided into the Ulcerative Colitis (UC) Group (1782 women), the Crohn Group (1954 women) and the Non-IBD Group (398,219 women). For each group, the dependent variable was preterm birth during 2015–2017, and 51 independent variables were included. Random forest variable importance was employed for investigating the main factors of preterm birth and testing its associations with salivary gland disease, socioeconomic status and medication history for each group. The proportion of preterm birth was higher for the UC Group and the Non-IBD Group than for the Crohn Group: 7.86%, 7.17% vs. 6.76%. Based on random forest variable importance, salivary gland disease was a top 10 determinant for the prediction of preterm birth for the UC Group, but this was not the case for the Crohn Group or the Non-IBD Group. The top 5 variables of preterm birth for the UC Group during 2015–2017 were socioeconomic status (8.58), age (8.00), proton pump inhibitors (2.35), progesterone (2.13) and salivary gland disease in 2014 (1.72). In conclusion, preterm birth has strong associations with ulcerative colitis, salivary gland disease, socioeconomic status and medication history including proton pump inhibitors. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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12 pages, 1626 KiB  
Article
Comparison between Cervical Ureaplasma spp. Colonization and the Intensity of Inflammatory Mediators in the Amniotic Fluid Retrieved during Cesarean Delivery in Preterm Birth
Int. J. Environ. Res. Public Health 2022, 19(1), 107; https://doi.org/10.3390/ijerph19010107 - 23 Dec 2021
Cited by 1 | Viewed by 2276
Abstract
We investigated whether cervical Ureaplasma spp. colonization affects the intensity of inflammatory mediators in amniotic fluid retrieved during cesarean delivery in singleton preterm birth. One hundred fifty-three cases in singleton preterm birth with 24–34 weeks’ gestation were enrolled. The intensities of seven inflammatory [...] Read more.
We investigated whether cervical Ureaplasma spp. colonization affects the intensity of inflammatory mediators in amniotic fluid retrieved during cesarean delivery in singleton preterm birth. One hundred fifty-three cases in singleton preterm birth with 24–34 weeks’ gestation were enrolled. The intensities of seven inflammatory mediators (interleukin (IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α, and matrix metalloproteins (MMP)-8, MMP-9) of amniotic fluid were measured. We tested cervical swab specimens using real-time polymerase chain reaction assays to detect Ureaplasma spp. colonization. Histologic chorioamnionitis (HCA) was diagnosed when acute inflammation was observed in any of the placental tissues. Mean gestational age at delivery and birth weight were 30.9 ± 2.4 weeks and 1567 ± 524 g, respectively. Cervical Ureaplasma spp. colonization was detected 78 cases. The incidence of HCA was 32.3% (43/133). Although the intensities of all inflammatory mediators were significantly different according to presence or absence of HCA, there were no significant differences according to cervical Ureaplasma spp. colonization. In all 43 cases with HCA and 90 cases without HCA, there were no significant differences between cervical Ureaplasma spp. colonization and the intensity of inflammatory mediators. Cervical Ureaplasma spp. colonization did not affect the intensity of inflammatory mediators in the amniotic fluid retrieved during cesarean delivery. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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11 pages, 648 KiB  
Article
A Cross-Sectional Study to Assess the Frequency and Risk Factors Associated with Cesarean Section in Southern Punjab, Pakistan
Int. J. Environ. Res. Public Health 2021, 18(16), 8812; https://doi.org/10.3390/ijerph18168812 - 21 Aug 2021
Cited by 5 | Viewed by 4193
Abstract
The increasing frequency of cesarean section (CS) is a major public health issue, and it is on the rise in Pakistan. A cross-sectional study approach was used to assess the frequency of CS and its contributing factors, along with the assessment of knowledge [...] Read more.
The increasing frequency of cesarean section (CS) is a major public health issue, and it is on the rise in Pakistan. A cross-sectional study approach was used to assess the frequency of CS and its contributing factors, along with the assessment of knowledge in mothers who had undergone CS in one of the under-developed regions of Pakistan. Data collection was done by using a self-developed study questionnaire. The statistical package for social sciences (SPSS) was utilized for the statistical analysis. During the study period, a total of 173 (69.7%) women have given births by CS; among those, 104 (60.1%) were elective/planned CSs while 69 (39.8%) were emergency CSs. The higher CS frequency was significantly associated with younger age (p = 0.03) and pre-term gestational age (p < 0.001). Pregnancy complications, such as gestational diabetes, hypertension, preeclampsia/eclampsia, and vaginal bleeding, were the significant risk factors for CS (p < 0.001). The highlighted contributing factors to CS in the current study were preterm of gestational age, mothers of a younger age (20–24 years), and mothers that belong to urban populations. These risk factors can be addressed by implementing community-focused educational interventions during the gestational period. The sample size in this study was small; therefore, the results cannot be generalized to the whole population. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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17 pages, 1704 KiB  
Article
The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(6), 2951; https://doi.org/10.3390/ijerph18062951 - 13 Mar 2021
Cited by 15 | Viewed by 2572
Abstract
The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function [...] Read more.
The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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12 pages, 3018 KiB  
Article
The Feasibility of Cervical Elastography in Predicting Preterm Delivery in Singleton Pregnancy with Short Cervix Following Progesterone Treatment
Int. J. Environ. Res. Public Health 2021, 18(4), 2026; https://doi.org/10.3390/ijerph18042026 - 19 Feb 2021
Cited by 8 | Viewed by 3088
Abstract
Previous studies demonstrated an association between cervical strain and risk of spontaneous preterm delivery (sPTD). The present study aimed to assess the efficacy of elastography in predicting sPTD at <32 weeks of gestation in women with singleton pregnancies receiving progesterone for short cervix [...] Read more.
Previous studies demonstrated an association between cervical strain and risk of spontaneous preterm delivery (sPTD). The present study aimed to assess the efficacy of elastography in predicting sPTD at <32 weeks of gestation in women with singleton pregnancies receiving progesterone for short cervix (≤2.5 cm) diagnosed between 16 and 28 weeks of gestation Among 115 participants eligible for analysis, nine had sPTD at <32 weeks. Preprogesterone (PP0) mean internal os strain (IOS), elasticity contrast index (ECI), hardness ratio (HR), one-week postprogesterone (PP1) IOS, mean external os strain (EOS), ECI, and HR were significantly different between groups. Higher PP0 IOS, PP1 IOS, and PP1 EOS were associated with a 2.92, 4.39 and 3.65-fold increase in the risk of sPTD at <32 weeks, respectively (adjusted for cervical length (CL) at diagnosis; p = 0.04, 0.012 and 0.026, respectively). A combination of CL at diagnosis, PP0 IOS and PP1 EOS showed a significantly higher area under the receiver operating characteristic curve (0.858) than that of CL alone (p = 0.041). In women with singleton pregnancies receiving progesterone for short cervix, cervical elastography performed before and one week after progesterone treatment may be useful in predicting sPTD at <32 weeks of gestation. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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9 pages, 796 KiB  
Article
Perinatal Outcomes Associated with Latency in Late Preterm Premature Rupture of Membranes
Int. J. Environ. Res. Public Health 2021, 18(2), 672; https://doi.org/10.3390/ijerph18020672 - 14 Jan 2021
Cited by 9 | Viewed by 2648
Abstract
This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + [...] Read more.
This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006–2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery ≥72 h vs. immediate delivery <72 h). Data were compared among 345 women (expectant, n = 39; immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p < 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (≥72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM. Full article
(This article belongs to the Special Issue Prediction and Prevention of Preterm Birth: Now and Future)
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