Does Group Prenatal Care Reduces Preterm Birth Risk?

image credit: ogpnews.com

A new study of more than 9,000 women compared those who received either CenteringPregnancy or Expect With Me group prenatal care to those who received traditional one-on-one care.

Researchers found that group prenatal care patients had a 37 percent lower risk of having a preterm birth and a 38 percent lower risk of having a low birth weight baby than women receiving traditional one-on-one care. Better attendance at the group visits also lead to more pronounced benefits.

Women with five or more group prenatal care visits had a 68 percent lower risk of having a preterm birth and a 66 percent lower risk of having a low birth weight baby than their peers receiving traditional care.

These findings come from the largest study comparing group prenatal care to traditional one-on-one care, to date.

“The health benefits of group prenatal care are enormous,” says coauthor Jessica Lewis, deputy director of pregnancy research at Yale University’s School of Public Health. “Preterm birth and low birth weight are the second leading causes of infant mortality in the US, and cost more than $38 billion dollars per year.”

Progesterone to fight preterm birth

via micro.magent.fsu.edu

"A new study published today (17.11.17) -- World Prematurity Day -- in the American Journal of Obstetrics & Gynecology provides additional support for treatment with vaginal progesterone to reduce the risk of preterm birth, neonatal complications and infant death in pregnant women with a short cervix. A shortened cervix is the most powerful predictor of preterm birth.

A meta-analysis of individual patient data by researchers at the Perinatology Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the Wayne State University School of Medicine and the Detroit Medical Center, further validates the use of vaginal progesterone to decrease the risk of preterm birth and improve perinatal outcomes in women with a single pregnancy found via sonography to have a short cervix. Vaginal progesterone therapy to reduce preterm birth was developed at the PRB in 2011.

The findings are welcome news in the fight against preterm birth, the leading cause of death in children younger than 5. The March of Dimes annual report on preterm birth for 2017 indicates that the rate of preterm birth in the United States climbed for the second consecutive year in 2016 after nearly a decade of decline.

The 2017 March of Dimes Premature Birth Report Card provides preterm birth rates and grades for all 50 states, plus the District of Columbia and Puerto Rico, based on birth data from the National Center for Health Statistics. The latest report card puts the national preterm birth rate at 9.8 percent (a C grade), an increase from the rate of 9.6 percent in 2015. Preterm birth rates worsened in 43 states, the District of Columbia and Puerto Rico. Only four states received an A grade. Michigan, with its 10.1 percent rate, ranked worse than 26 states and received a C grade..."

Learn more:

https://www.sciencedaily.com/releases/2017/11/171117115452.htm

Sleep disorders in pregnancy linked to preterm birth

babycentre.co.uk

"Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term, according to an analysis of California births by researchers at UC San Francisco.

The study found the prevalence of preterm birth -- defined as delivery before 37 weeks' gestation -- was 14.6 percent for women diagnosed with a sleep disorder during pregnancy, compared to 10.9 percent for women who were not. The odds of early preterm birth -- before 34 weeks -- was more than double for women with sleep apnea and nearly double for women with insomnia. Complications are more severe among early preterm births, which makes this latter finding particularly important, the authors said.

In contrast to the normal sleep changes that typically occur during pregnancy, the new study focused on major disruptions likely to result in impairment. The true prevalence of these disorders is unknown because pregnant women often go undiagnosed. Treating sleep disorders during pregnancy could be a way to reduce the preterm rate, which is about 10 percent in the United States, more than most other highly developed countries.

The study, published Aug. 8, 2017 in Obstetrics & Gynecology, is the first to examine the effects of insomnia during pregnancy. Because of a large sample size, the authors were able to examine the relationship between different types of sleep disorders and subtypes of preterm birth (for example, early vs. late preterm birth, or spontaneous preterm labor vs. early deliveries that were initiated by providers due to mothers' health issues)..."

Learn more:https://www.sciencedaily.com/releases/2017/08/170808182345.htm

 

Vaginal progesterone reduces the rate of preterm birth

via medscape.com

"Treatment with vaginal progesterone reduced the risk of preterm birth, neonatal complications and death in pregnant women with twins and who have a short cervix -- a risk factor for preterm birth -- according to a meta-analysis of individual patient data by researchers at the National Institutes of Health, the Wayne State University School of Medicine, the Detroit Medical Center, and other institutions in the United States and abroad.

Births occurring before the 37th week of pregnancy are considered preterm. Preterm birth increases the risk for infant death and long term disability. Twin pregnancies present a five- to six-time increased risk for preterm birth.

In preparation for birth, the cervix (lower part of the uterus) thins and shortens during pregnancy. In some women, the cervix shortens prematurely, as early as the fourth or fifth month of pregnancy. The natural hormone progesterone (also called the "pregnancy hormone"), inserted in the vagina either as a gel or tablet has been shown to decrease the risk for preterm birth associated with a short cervix in women with a single fetus in previous conducted by NIH and WSU investigators.

The new study, "Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data," was published in Ultrasound in Obstetrics and Gynecology. An accompanying video explaining the study's findings can be viewed at http://www2.med.wayne.edu/prb/progesterone.htm..."

Learn more:

https://www.sciencedaily.com/releases/2017/03/170307100433.htm