Triggers of Spontaneous Preterm Delivery – Why Today?. Issue 2 (2nd January 2014)

• Record Type: Journal Article
• Authors: Hernández‐Díaz, Sonia; Boeke, Caroline E.; Romans, Anna Thornton; Young, Brett; Margulis, Andrea V.; McElrath, Thomas F.; Ecker, Jeffrey L.; Bateman, Brian T.
• Is Part Of: Paediatric and perinatal epidemiology. Volume 28:Issue 2(2014)
• Page Start: 79
• Page End: 87
• Publication Date: 2014-01-02
• Subjects: Pediatrics -- Periodicals; Perinatology -- Periodicals; Pediatric epidemiology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; 618.92
• DOI: 10.1111/ppe.12105
• Languages: English
• ISSNs: 0269-5022

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ppe12105-sec-0001" sec-type="section"> <title>Background</title> <p>Our goal is to study the triggers of spontaneous preterm delivery using a case‐crossover design.</p> </sec> <sec id="ppe12105-sec-0002" sec-type="section"> <title>Methods</title> <p>In a pilot study, we enrolled 50 women with spontaneous preterm labour (PTL) and 50 with preterm premature rupture of membranes (PPROM) between 2011 and 2012. To assess non‐transient risk factors, we also enrolled a control group of 158 pregnant women at their regular prenatal care visits matched to cases by gestational age and calendar time. The index time was defined as the onset of PTL/PPROM (for cases) or interview (for controls). Detailed data were collected through structured interviews regarding factors of interest during the 72 h that preceded the index time. Within case subjects, we compared the frequency of transient factors from 0 to 24 h before index time with that from 48 to 72 h before index time, and estimated matched odds ratios (OR) and 95% confidence intervals (CI).</p> </sec> <sec id="ppe12105-sec-0003" sec-type="section"> <title>Results</title> <p>Previously hypothesised chronic risk factors for spontaneous preterm delivery, including mood disorders and stressful events, were more common among cases than among controls. Within cases, skipped meals [OR 4.3, 95% CI 1.2, 15.2], disturbed sleep [OR 4.5, 95% CI 1.5, 13.3], sexual activity [OR 6.0, 95% CI 0.7, 69.8], and intake of spicy foods [OR 7.0, 95% CI 1.6, 30.8] were associated with an increased risk for PTL/PPROM within the subsequent 24 h. For physical exertion and other potential risk factors evaluated, the OR was close to the null.</p> </sec> <sec id="ppe12105-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Skipping meals and disturbed sleep may be associated with imminent PTL/PPROM; sexual activity and spicy food may trigger PTL/PPROM in susceptible women. Larger case‐crossover studies will be able to evaluate the impact of modifiable risk factors and acute predictors of PTL/PPROM, and might help guide obstetrical management.</p> </sec> </abstract>