Original researchRecurrence of preterm birth in singleton and twin pregnancies
Section snippets
Materials and methods
Women with consecutive pregnancies, beginning with their first birth, and who were delivered at our hospital between January 1, 1988, and December 31, 1999, were identified using a computerized database. This database contains selected obstetric and neonatal outcomes for all women delivering infants at Parkland Hospital in Dallas, Texas. Nurses attending each delivery completed an obstetric data sheet, and research nurses prospectively reviewed all mother-infant charts to ensure completeness
Results
A total of 169,751 women delivered during the study period of which 15,945 (9%) were nulliparous women who ultimately delivered their first two or more consecutive pregnancies at our hospital and made up the study cohort. A total of 36,365 singleton infants were delivered of these women. The overall rate of spontaneous birth less than 35 weeks was 4% for women with singletons and 33% for those with twins. Shown in Table 1 is a comparison of demographic factors in women with or without singleton
Discussion
The results of our study suggest that when assessing a woman’s future risk of delivering a preterm infant based upon her obstetric history, several points must be considered. First, an obstetric history complicated by a twin delivery before 35 weeks’ gestation did not significantly increase subsequent risk for recurrence. Second, women whose first pregnancy ended in delivery of a singleton infant before 35 weeks were at increased risk of recurrence, and the cause of the first preterm birth also
References (15)
- et al.
Prognostic significance of prior preterm twin delivery on subsequent singleton pregnancy
Am J Obstet Gynecol
(1996) Gestational duration in the pregnancy after a preterm twin delivery
Am J Obstet Gynecol
(1998)- et al.
The preterm prediction studyRisk factors in twin gestations
Am J Obstet Gynecol
(1996) - et al.
The tendency to repeat gestational age and birth weight in successive births
Am J Obstet Gynecol
(1979) - et al.
Implications of idiopathic preterm delivery for previous and subsequent pregnancies
Obstet Gynecol
(1995) - et al.
The preterm prediction studyThe value of new vs. standard risk factors in predicting early and all spontaneous preterm births
Am J Public Health
(1998) - et al.
Rates of and factors associated with recurrence of preterm delivery
JAMA
(2000)
Cited by (131)
What now? A critical evaluation of over 20 years of clinical and research experience with 17-alpha hydroxyprogesterone caproate for recurrent preterm birth prevention
2023, American Journal of Obstetrics and Gynecology MFMElevated midtrimester maternal plasma cytokines and preterm birth in patients with cerclage
2022, American Journal of Obstetrics and Gynecology MFMDoes vaginal progesterone prevent recurrent preterm birth in women with a singleton gestation and a history of spontaneous preterm birth? Evidence from a systematic review and meta-analysis
2022, American Journal of Obstetrics and GynecologyA chronicle of the 17-alpha hydroxyprogesterone caproate story to prevent recurrent preterm birth
2021, American Journal of Obstetrics and GynecologyCitation Excerpt :As outlined in the foregoing text, the efficacy of 17OHP-C was entirely dependent on a placebo group with a rate of recurrent PTB of 54%—which was associated with the asymmetry of the 2 study arms such that the placebo group included substantially more women with multiple previous PTBs.6,14,16 The number of previous PTBs is a powerful determinant of recurrence.19,20 For example, the recurrence rate in women at Parkland Hospital with 1 previous PTB was 18% (<35 weeks’ gestation) compared with the recurrence rate of 45% in women with 3 previous PTBs.21
Risk of singleton preterm birth after prior twin preterm birth: a systematic review and meta-analysis
2020, American Journal of Obstetrics and GynecologyCitation Excerpt :The Rydhstroem6 study also could not be incorporated into the meta-analysis because of the definition of PTB (<36 weeks gestation) and lack of a term twin control group. The study by Bloom et al7 included 82 women with twins (49 term; 33 preterm) who went on to have a singleton birth. The authors used 35 weeks gestation as the definition of prematurity for all analyses.
Endocrinology of Human Pregnancy and Fetal-Placental Neuroendocrine Development
2019, Yen & Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management: Eighth Edition