Preeclampsia, preterm birth linked to greater preterm birth risks in later pregnancies
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Women who had a premature baby after developing preeclampsia were 17 times more likely to have another preterm birth if they had preeclampsia again, according to a study published in the British Journal of Obstetrics and Gynecology.
Noting that preterm birth is the leading cause of death and morbidity in children up to age 5 years in the developed world, the researchers said they examined 125,473 women who gave birth to their first and second singleton children in Western Australia from 1998 to 2015.
The researchers also called their findings the strongest link between preterm birth and pregnancies complicated by preeclampsia.
“When both pregnancies were complicated by preeclampsia, the risk of a subsequent preterm birth increased tenfold after an initial term birth and 17-fold when the first birth was preterm, compared to women who had an uncomplicated first pregnancy,” author Jennifer Dunne, a PhD candidate at the Curtin University School of Population Health, said in a press release.
Also, the researchers found a threefold higher risk of women experiencing a subsequent case of preeclampsia after a preterm birth in the first pregnancy that was not complicated by preeclampsia.
“Until recently, a first birth at full term was considered a reduced risk for a preterm delivery in the next pregnancy. However, there is emerging evidence that a complicated first pregnancy, regardless of whether the baby was delivered early or at full term, increases the subsequent risk of a baby being born prematurely,” Dunne said.
The main pregnancy complications examined included preeclampsia, placental abruption, small for gestational age and perinatal death. Women who experienced any of these four complications in their first pregnancy saw an increased risk for preterm birth in their next pregnancy regardless of whether that first birth ended at full term or preterm.
“Likewise, women whose first pregnancy ended in a preterm delivery were at an increased risk for each pregnancy complication in the second pregnancy,” Dunne said.
The researchers said these findings will help clinicians better identify women at increased risk for a preterm birth or for complications in subsequent pregnancies.
“Further research is now needed to reveal the specific pathways that explain these strong links between pregnancy complications and preterm births, whether they be genetic, pathological, behavioral or other recurrent issues,” said Dunne.