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ORIGINAL RESEARCH |
From the Laboratory of Perinatal Medicine, Perinatal Medicine Unit, Department of Obstetrics and Gynecology, Pathology, and Medical Research Center, Pontificia Universidad Católica de Chile School of Medicine, Santiago, Chile; and San Bernardino County Medical Center, San Bernardino, California.
Address reprint requests to: Alfredo M. Germain, MD Department of Obstetrics and Gynecology Pontificia Universidad Católica de Chile PO Box 114-D Santiago Chile E-mail: agermain{at}med.puc.cl
Objective: To determine the relevance of ischemia in the incidence of preterm labor. A second objective was to document perinatal outcomes for patients with preterm labor classified according to its clinical, functional, and pathologic characteristics (infectious, ischemic, mixed, or idiopathic).
Methods: Perinatal outcomes were evaluated for 145 consecutive patients with preterm labor, subdivided into etiologic categories according to clinical, functional (Doppler), and morphologic (placental pathology) characteristics. A group of 44 normal pregnancies delivered at term served as controls.
Results: Of the preterm labor group, 28.3% were classified as ischemic, compared with 4.5% of the control group (odds ratio and 95% confidence interval = 8.28 [1.8, 51.8]; P < .05). Compared with the control group, the preterm labor patients who delivered preterm had higher rates of ischemia (31.4% compared with 4.5%; P < .05) and infection (16.1% compared with 2.3%; P < .05). Among the preterm labor group, patients classified in the infectious or ischemic subgroups had a higher rate of preterm delivery (95.0% and 90.2% compared with 73.2%; P < .05), admission to the neonatal intensive care unit (75.0% and 61.0% compared with 40.0%; P < .05), and newborn weight under 1500 g (35.0% and 19.5% compared with 3.7%; P < .05) than the idiopathic subgroup.
Conclusion: Preterm labor resulting from infection or ischemia is associated with a higher perinatal complication rate than idiopathic preterm labor.
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