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Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

dc.contributor.authorSouza, Renato T.
dc.contributor.authorCosta, Maria L.
dc.contributor.authorMayrink, Jussara
dc.contributor.authorFeitosa, Francisco E.
dc.contributor.authorRocha Filho, Edilberto A.
dc.contributor.authorLeite, Débora F.
dc.contributor.authorVettorazzi, Janete
dc.contributor.authorCalderon, Iracema M. [UNESP]
dc.contributor.authorSousa, Maria H.
dc.contributor.authorPassini, Renato
dc.contributor.authorBaker, Philip N.
dc.contributor.authorKenny, Louise
dc.contributor.authorCecatti, Jose G.
dc.contributor.authorParpinelli, Mary A.
dc.contributor.authorFernandes, Karayna G.
dc.contributor.authorGalvão, Rafael B.
dc.contributor.authorGuida, José Paulo
dc.contributor.authorSantana, Danielly S.
dc.contributor.authorde Lucena, Daisy
dc.contributor.authorSousa, Benedita
dc.contributor.authorMelo, Elias F.
dc.contributor.authorAnacleto, Danilo
dc.contributor.authorPfitscher, Lucia
dc.contributor.authorBrust, Luiza
dc.contributor.authorCassettari, Bianca F. [UNESP]
dc.contributor.authorFranchini, Kleber G.
dc.contributor.authorPacagnella, Rodolfo C.
dc.contributor.institutionUniversidade Estadual de Campinas (UNICAMP)
dc.contributor.institutionMEAC – School Maternity of the Federal University of Ceará
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionFederal University of RS
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionJundiai School of Medicine
dc.contributor.institutionUniversity of Leicester
dc.contributor.institutionUniversity of Liverpool
dc.date.accessioned2020-12-12T02:08:24Z
dc.date.available2020-12-12T02:08:24Z
dc.date.issued2020-12-01
dc.description.abstractPreterm birth is the major contributor for neonatal and under-five years mortality rates and also accounts for a short- and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with different categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in five maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19–21weeks, 27–29 weeks and 37–39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37–38 weeks) were compared to full term birth (39–40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sPTB and pi-PTb were associated with poorer perinatal outcomes, as well as late sPTB, late pi-PTB and early term neonates. pi-PTB (RRadj 8.12, 95% CI [2.54–25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks <p10 (RRadj 2.04, 95% CI [1.23–3.38], p-value 0.018) and participants from the Northeast centres (RRadj 2.35, 95% CI [1.11–4.95], p-value 0.034) were independently associated with APO. According to our findings, Brazil would benefit from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term provider-initiated deliveries, and to prevent perinatal adverse outcomes.en
dc.description.affiliationDepartment of Obstetrics and Gynaecology University of Campinas (UNICAMP) School of Medical Sciences
dc.description.affiliationMEAC – School Maternity of the Federal University of Ceará
dc.description.affiliationDepartment of Maternal and Child Health Maternity of Clinic Hospital Federal University of Pernambuco
dc.description.affiliationDepartment of Obstetrics and Gynaecology Maternity of the Clinic Hospital Federal University of RS
dc.description.affiliationDepartment of Obstetrics and Gynaecology Botucatu Medical School Unesp
dc.description.affiliationStatistics Unit Jundiai School of Medicine
dc.description.affiliationCollege of Life Sciences University of Leicester
dc.description.affiliationFaculty of Health and Life Sciences University of Liverpool
dc.description.affiliationLNBio - Brazilian Biosciences National Laboratory and School of Medical Sciences University of Campinas (UNICAMP)
dc.description.affiliationUnespDepartment of Obstetrics and Gynaecology Botucatu Medical School Unesp
dc.identifierhttp://dx.doi.org/10.1038/s41598-020-65022-z
dc.identifier.citationScientific Reports, v. 10, n. 1, 2020.
dc.identifier.doi10.1038/s41598-020-65022-z
dc.identifier.issn2045-2322
dc.identifier.scopus2-s2.0-85085264508
dc.identifier.urihttp://hdl.handle.net/11449/200507
dc.language.isoeng
dc.relation.ispartofScientific Reports
dc.sourceScopus
dc.titlePerinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous womenen
dc.typeArtigo
dspace.entity.typePublication
unesp.campusUniversidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatupt
unesp.departmentGinecologia e Obstetrícia - FMBpt

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