Maternal characteristics and mid-pregnancy serum biomarkers as risk factors for subtypes of preterm birth

L L Jelliffe-Pawlowski; R J Baer; Y J Blumenfeld; K K Ryckman; H M O'Brodovich; J B Gould; M L Druzin; Y Y El-Sayed; D J Lyell; D K Stevenson; G M Shaw; R J Currier

doi:10.1111/1471-0528.13495

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Maternal characteristics and mid-pregnancy serum biomarkers as risk factors for subtypes of preterm birth

Journal article

Peer reviewed

Maternal characteristics and mid-pregnancy serum biomarkers as risk factors for subtypes of preterm birth

L L Jelliffe-Pawlowski, R J Baer, Y J Blumenfeld, K K Ryckman, H M O'Brodovich, J B Gould, M L Druzin, Y Y El-Sayed, D J Lyell, D K Stevenson, …

BJOG : an international journal of obstetrics and gynaecology, Vol.122(11), pp.1484-1493

10/2015

DOI: 10.1111/1471-0528.13495

PMCID: PMC4704442

PMID: 26111589

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Abstract

To examine the relationship between maternal characteristics, serum biomarkers and preterm birth (PTB) by spontaneous and medically indicated subtypes. Population-based cohort. California, United States of America. From a total population of 1 004 039 live singleton births in 2009 and 2010, 841 665 pregnancies with linked birth certificate and hospital discharge records were included. Characteristics were compared for term and preterm deliveries by PTB subtype using logistic regression and odds ratios adjusted for maternal characteristics and obstetric factors present in final stepwise models and 95% confidence intervals. First-trimester and second-trimester serum marker levels were analysed in a subset of 125 202 pregnancies with available first-trimester and second-trimester serum biomarker results. PTB by subtype. In fully adjusted models, ten characteristics and three serum biomarkers were associated with increased risk in each PTB subtype (Black race/ethnicity, pre-existing hypertension with and without pre-eclampsia, gestational hypertension with pre-eclampsia, pre-existing diabetes, anaemia, previous PTB, one or two or more previous caesarean section(s), interpregnancy interval ≥ 60 months, low first-trimester pregnancy-associated plasma protein A, high second-trimester α-fetoprotein, and high second-trimester dimeric inhibin A). These risks occurred in 51.6-86.2% of all pregnancies ending in PTB depending on subtype. The highest risk observed was for medically indicated PTB <32 weeks in women with pre-existing hypertension and pre-eclampsia (adjusted odds ratio 89.7, 95% CI 27.3-111.2). Our findings suggest a shared aetiology across PTB subtypes. These commonalities point to targets for further study and exploration of risk reduction strategies. Findings suggest a shared aetiology across preterm birth subtypes. Patterns may inform risk reduction efforts.

Pregnancy Trimester, First - blood

Premature Birth - classification

Anemia - epidemiology

Humans

Cesarean Section - statistics & numerical data

Birth Intervals

Premature Birth - blood

alpha-Fetoproteins - analysis

Young Adult

Adult

Female

Inhibins - blood

Pregnancy Trimester, Second - blood

Hypertension - epidemiology

Continental Population Groups

Pregnancy-Associated Plasma Protein-A - analysis

California - epidemiology

Risk Factors

Logistic Models

Biomarkers - blood

Premature Birth - epidemiology

Diabetes Mellitus - epidemiology

Adolescent

Pregnancy - blood

Pregnancy Complications - epidemiology

Cohort Studies

Details

Title: Subtitle: Maternal characteristics and mid-pregnancy serum biomarkers as risk factors for subtypes of preterm birth
Creators: L L Jelliffe-Pawlowski - Department of Epidemiology and Biostatistics, Division of Preventive Medicine and Public Health, University of California, San Francisco School of Medicine, San Francisco, CA, USA
R J Baer - Genetic Disease Screening Program, California Department of Public Health, Richmond, CA, USA
Y J Blumenfeld - Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA
K K Ryckman - Department of Epidemiology, University of Iowa, Iowa City, IA, USA
H M O'Brodovich - Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
J B Gould - California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
M L Druzin - Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA
Y Y El-Sayed - Department of Epidemiology and Biostatistics, Division of Preventive Medicine and Public Health, University of California, San Francisco School of Medicine, San Francisco, CA, USA
D J Lyell - Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA
D K Stevenson - Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
G M Shaw - Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
R J Currier - Genetic Disease Screening Program, California Department of Public Health, Richmond, CA, USA
Resource Type: Journal article
Publication Details: BJOG : an international journal of obstetrics and gynaecology, Vol.122(11), pp.1484-1493
DOI: 10.1111/1471-0528.13495
PMID: 26111589
PMCID: PMC4704442
NLM abbreviation: BJOG
ISSN: 1471-0528
eISSN: 1471-0528
Publisher: England
Grant note: R00 HD065786 / NICHD NIH HHS
Language: English
Date published: 10/2015
Academic Unit: Stead Family Department of Pediatrics; Epidemiology
Record Identifier: 9983995170802771

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