Preterm delivery elevates risk of early mortality in women

Preterm delivery elevates risk of early mortality in women

Preterm birth may be an independent risk factor for early mortality in women, suggest a recent observational study published in the journal BMJ.

Dr Casey Crump and colleagues from the Icahn School of Medicine at Mount Sinai conducted a national cohort study of women in Sweden to evaluate preterm birth and mortality using data from the Swedish Medical Birth Register and the country’s death registry. The study included singleton deliveries that occurred from 1973 to 2015 and evaluated mortality through 2016.

The study defined preterm delivery as delivery before 37 weeks gestation; extremely preterm delivery from 22 to 27 weeks gestation; very preterm as 28 to 33 weeks gestation; later preterm as 34 to 36 weeks gestation; early term as 37 to 38 weeks gestation; and full-term delivery as 39 to 41 weeks gestation.

A total of 2,189,477 women were evaluated in the study. Of those, 3.5% died during follow-up, with a median age of 57.6 years at death.

The researchers found that in the 10 years following delivery, the risk for all-cause mortality in women with preterm delivery was 1.73 compared with women who had a full-term delivery. From 0 to 44 years of follow-up after delivery, the risk for death was 4% lower with an additional week of pregnancy. Compared with women who had full-term delivery the risk for all-cause mortality in the 10 years following delivery was higher in women with extremely preterm delivery, very preterm delivery, late preterm delivery and early term delivery.

Compared with women who had full-term delivery, preterm delivery was associated with elevated risks for mortality from CV disorders, cancer, respiratory condition and diabetes during the entire follow-up period.

The researchers said the specific processes involved in premature delivery may directly contribute to the development of chronic conditions or early death in women, and potential mechanisms may involve inflammatory pathways, preclinical diabetes or cardiometabolic disorders and vitamin D deficiency.

“Women who deliver preterm have been reported to have increased future risks of developing cardiometabolic disorders, even after controlling for other risk factors,” Dr Crump, vice chair for research of the Alfred and Gail Engelberg Department of Family Medicine and Community Health in, and colleagues wrote.

Medical records and history taking should routinely include reproductive history that covers preterm delivery and other complications of pregnancy, noted the researchers.

Dr Casey Crump and colleagues from the Icahn School of Medicine at Mount Sinai conducted a national cohort study of women in Sweden to evaluate preterm birth and mortality using data from the Swedish Medical Birth Register and the country’s death registry. The study included singleton deliveries that occurred from 1973 to 2015 and evaluated mortality through 2016.

The study defined preterm delivery as delivery before 37 weeks gestation; extremely preterm delivery from 22 to 27 weeks gestation; very preterm as 28 to 33 weeks gestation; later preterm as 34 to 36 weeks gestation; early term as 37 to 38 weeks gestation; and full-term delivery as 39 to 41 weeks gestation.

A total of 2,189,477 women were evaluated in the study. Of those, 3.5% died during follow-up, with a median age of 57.6 years at death.

The researchers found that in the 10 years following delivery, the risk for all-cause mortality in women with preterm delivery was 1.73 compared with women who had a full-term delivery. From 0 to 44 years of follow-up after delivery, the risk for death was 4% lower with an additional week of pregnancy. Compared with women who had full-term delivery the risk for all-cause mortality in the 10 years following delivery was higher in women with extremely preterm delivery, very preterm delivery, late preterm delivery and early term delivery.

Compared with women who had full-term delivery, preterm delivery was associated with elevated risks for mortality from CV disorders, cancer, respiratory condition and diabetes during the entire follow-up period.

The researchers said the specific processes involved in premature delivery may directly contribute to the development of chronic conditions or early death in women, and potential mechanisms may involve inflammatory pathways, preclinical diabetes or cardiometabolic disorders and vitamin D deficiency.

“Women who deliver preterm have been reported to have increased future risks of developing cardiometabolic disorders, even after controlling for other risk factors,” Dr Crump, vice chair for research of the Alfred and Gail Engelberg Department of Family Medicine and Community Health in, and colleagues wrote.

Medical records and history taking should routinely include reproductive history that covers preterm delivery and other complications of pregnancy, noted the researchers.