Abstract | OBJECTIVE: The objective of the study was to estimate and compare the relative risk of preterm birth (PTB) in pregnancies complicated by 1 or more of 8 major congenital malformations (MCMs). STUDY DESIGN: This was a population-based cohort study of the birth database of the Missouri Department of Health (1989-1997) including 678,693 singleton live births. Outcomes included a binary composite variable of any MCM and the following 8 individual malformations: spina bifida, diaphragmatic hernia, renal agenesis, other urogenital anomaly, tracheoesophageal fistula/esophageal atresia, omphalocele/gastroschisis, cardiac defect, and cleft lip/palate. Chromosomal anomalies were excluded. Logistic regression analyses assessed the association between malformations and PTB. RESULTS: The risk of PTB increased significantly and to varying degrees for each malformation. In pregnancies with any MCM, there was an increased prevalence (11.5%) and relative risk (adjusted odds ratio [(adj)OR] 3.2 [95% confidence interval (CI) 2.9 to 3.6]) of PTB at less than 35 weeks' gestation. The magnitude of risk increase was greatest at the earliest gestational ages: (adj)OR 4.8 (95% CI, 4.0 to 5.7) at less than 28 weeks. Pregnancies with multiple malformations were at highest risk for PTB: (adj)OR 8.0 [95% CI, 4.6 to 14.1]. CONCLUSION: MCMs significantly increase PTB risk. The risk varies by malformation type and is higher with multiple malformations.
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Authors | Stephanie E Purisch, Emily A DeFranco, Louis J Muglia, Anthony O Odibo, David M Stamilio |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 199
Issue 3
Pg. 287.e1-8
(Sep 2008)
ISSN: 1097-6868 [Electronic] United States |
PMID | 18771986
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Abnormalities, Multiple
(epidemiology)
- Adult
- Cleft Lip
(epidemiology)
- Cleft Palate
(epidemiology)
- Female
- Gastroschisis
(epidemiology)
- Heart Defects, Congenital
(epidemiology)
- Hernia, Diaphragmatic
(epidemiology)
- Hernia, Umbilical
(epidemiology)
- Humans
- Logistic Models
- Pregnancy
- Premature Birth
(epidemiology)
- Risk Factors
- Spinal Dysraphism
(epidemiology)
- Tracheoesophageal Fistula
(epidemiology)
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