Trusted Information for Healthy Pregnancies
preterm labor
Simple test can spot premature birth false alarms
Dec 8th
A simple test can help reliably determine whether signs of an imminent premature delivery are likely to result in a false alarm, research suggests.
Less than half of women showing these signs actually go on to give birth soon after, and they often have to undergo what turn out to be unnecessary tests.
UK researchers found a test that looks for a protein called fetal fibronectin (fFN) could solve the problem.
The study was conducted by University College London.
fFN is the protein that helps attach the foetal sac, in which the foetus develops, to the uterus.
Previous research has shown that when fFN is found to be leaking at a certain stage of pregnancy, a premature birth is more likely.
A test to detect fFN levels is relatively cheap and easy to perform - but it is not commonly used in all maternity units.
It is done at the same time as a vaginal examination, which is routinely carried out when a woman is admitted with abdominal pain in pregnancy.
If the results show low levels of fFN, then the chance of a women having a premature delivery imminently is low.
The researchers conducted an audit to determine whether use of the test made any significant difference.
Initially they analysed 22 cases of women admitted to hospital showing signs of being about to go into premature labor.
Of these, 17 did not give birth during their hospital stay, which averaged just more than eight days.
Most received steroid drugs to improve their baby's lung function, or tocolytic drugs to halt labor contractions.
The situation changed significantly after staff began to use the fFN test.
It proved to be 98.6% accurate in identifying women who, despite showing signs of premature delivery, did not go into labor for at least another two weeks.
As a result just seven women out of 78 who showed signs of being about to go into labor, but who registered low levels of fFN, required hospital treatment - for pain management.
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Preterm Births Higher Among Poor Mothers, Despite Equal Care
Dec 2nd
Despite improvements in obstetric care services, women from deprived areas are still more likely to give birth to a very preterm baby compared with mothers from more affluent areas, finds a study published on the British Medical Journal website.
Yet survival rates and provision of care was similar for infants from all areas, suggesting that neonatal care provision is equitable. A finding in contrast to many other areas of health care where socioeconomic inequalities in survival and access to care are common.
These findings highlight an urgent need to better understand the link between deprivation and risk of preterm birth, say the authors.
Researchers at the University of Leicester tracked 7,449 very preterm infants born 1998-2007 in the former Trent region of England from the onset of labor until discharge from neonatal care. A deprivation score was calculated for each infant using postcode data.
The authors point out that the data came only from one English region, which has about 54,000 births a year, representing one in 12 UK births, so the findings can't necessarily be extrapolated to different places. However, Trent does have a particularly good prospective dataset about births.
Their results show that mothers from the most deprived areas were nearly twice as likely to have a very preterm infant compared to those from the least deprived areas and consequently there were nearly twice as many deaths due to very preterm birth in the most deprived areas.
However, among very preterm infants, survival rates and neonatal care provision showed little variation across all deprivation measures. This suggests that, although socioeconomic inequalities in preterm birth rates persist, deprivation does not seem to be a barrier to accessing and receiving neonatal care.
This study did not look at individual factors such as smoking, ethnicity, and history of previous preterm birth. They believe that future studies should focus on the interplay between very preterm birth and the wider determinants of socioeconomic inequalities in health.
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Plastics Chemical Phthalate May Lead to Preterm Birth
Nov 30th
Pregnant women who are exposed to higher levels of an increasingly controversial chemical in certain plastics may deliver their babies slightly earlier than women with less exposure, results of a study suggest.
The chemical, DEHP - short for di(2-ethylhexyl)phthalate - is a "plasticizer" used widely in consumer products to help make vinyl plastic soft and flexible.
"Exposures (to DEHP) are ubiquitous," Dr. Robin M. Whyatt from Columbia Center for Children's Environmental Health in New York City told Reuters Health. DEHP breakdown products "have been detected in 95% of the general U.S. population."
In recent preliminary studies, DEHP exposure has been linked to some health risks. In animal studies, for example, exposure to this and other so-called phthalates has been linked to lower-weight babies and shorter pregnancies.
In preliminary human studies, prenatal DEHP exposure has been shown to affect the timing of labor; however, the findings have been mixed.
They gauged DEHP exposure by measuring four DEHP breakdown products in urine samples collected from the 311 African American or Dominican women aged 18 to 35. All of the women were living in New York City and were in their third trimesters.
The team found that the higher the level of DEHP breakdown products in the mothers' urine during pregnancy, the earlier the infant was born, Whyatt told Reuters Health. Babies with the highest level of exposure were born about five days earlier than those exposed to the lowest levels.
It's important to note, the researchers say, that the women in the study delivered their babies at or near term. However, if prenatal DEHP exposure were to lead to more infants being delivered prematurely, on average, this could be cause for concern.
Steve Risotto, Senior Director, Phthalate Esters, at the American Chemistry Council industry group, noted that two earlier studies contradicted the current one, showing opposite effects. "There was also no association found between phthalate exposure and prematurity, as all of the births were full term," he told Reuters Health.
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