Is uterine distention a factor in preterm delivery?

  • BMJ Open

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Preterm birth may be triggered by an interaction between uterine size and increasing uterine load (UL).

Why this matters

  • Preterm birth is the leading cause of adverse pregnancy outcomes.

Key results

  • Model 1: 
    • The timing of birth was more sensitive to maternal height (MH) in twin pregnancies;
    • A shorter mother with a twin pregnancy delivered earlier than expected for singleton pregnancies (OR, 56.2; 95% CI, 44.7-70.9).
  • Model 2: 
    • The timing of birth was more sensitive to MH in singleton pregnancies with large for gestational age (LGA) fetuses than singleton pregnancies with small for gestational age (SGA) fetuses;
    • A shorter mother with a LGA pregnancy delivered earlier than expected based on the trend for SGA pregnancy (OR, 10.2; 95% CI, 5.84-17.0).

Study design

  • Retrospective cohort study.
  • Uncomplicated pregnancies identified from the Swedish Medical Birth Register (n=530,888).
  • The relationship between UL (LGA, twin pregnancy vs singleton pregnancy), MH, and gestational age at birth was explored.
  • Funding: Swedish government grants to researchers in the public health sector; Swedish Research Council; March of Dimes Foundation; Burroughs Wellcome Fund Preterm Birth Research Grant.

Limitations

  • Maternal height is used as a proxy for uterine size.

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