Rise in preterm births linked to clinical intervention
Research at the 成人大片 shows preterm births in South Australia have increased by 40% over 28 years and early intervention by medical professionals has resulted in the majority of the increase.
Published this month in Obstetrics and Gynecology, the study was led by the Robinson Research Institute at the 成人大片.
Research author, PhD candidate Dr Petra Verburg from the University, analysed statistics for 550,000 births in South Australia between 1986 and 2014.
鈥淭he rate of preterm births (birth before 37 weeks鈥 gestation) increased by 40% from 5.1% in 1986 to 7.1% in 2014.
鈥淣atural鈥 or spontaneous preterm births accounted for the majority of all preterm births during the 28 years of the study. They rose from 3.5% in 1986 to 3.8% in 2014 鈥 only a modest increase,鈥 she says.
鈥淗owever, 80% of the increase in the rate of preterm births has been due to medical professionals ending pregnancies prematurely.
鈥淭he rate of clinician-initiated preterm delivery increased from 1.6% in 1986 to 3.2% in 2014.
Dr Verburg says, 鈥淐linicians may initiate preterm delivery due to pregnancy complications, by either inducing labour or performing a caesarean section.
鈥淧roblems such as hypertension or impaired growth of the fetus are the reasons doctors initiate the majority of preterm births鈥 she says.
While preterm birth rates have risen by 40%, the rate of stillbirths has fallen by 45% (4.2% 鈥 2.3%) in the same time period.
Co-author and Academic Head of the Department of Obstetrics & Gynaecology at the Lyell McEwin Hospital and University鈥檚 Robinson Research Institute Professor Gus Dekker says, 鈥淐urrently, more than a quarter of the South Australian pregnant population is obese or morbidly obese. Additionally, more than half are 30 years of age or older.鈥
鈥淭hese factors increase the likelihood of major pregnancy complications and hence, increase the likelihood that these pregnancies will end with a clinician indicated preterm birth.
鈥淥n the one hand, clinician-initiated preterm birth of growth restricted babies, or in cases of preeclampsia, may potentially prevent stillbirth, or maternal complications.
鈥淥n the other hand, babies born following totally uncomplicated pregnancies at term, have the best long-term health. Babies born preterm have a higher risk of type II diabetes, obesity and cardiac problems in later life.
鈥淣ew developments in ultrasounds and blood tests which indicate how well the placenta is functioning, may hopefully help obstetricians decide what the best time is to initiate birth in complicated pregnancies,鈥 says Professor Dekker.
This research has been supported by the National Health and Medical Research Council (NHMRC). [贵耻濒濒听厂迟辞谤测]