Maternal Risk Factors for Preterm Birth in Murmansk County, Russia: A Registry-Based Study
Corresponding Author
Anna A. Usynina
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Correspondence:
Anna A. Usynina, Northern State Medical University, 51, Troitsky Ave., Arkhangelsk 163000, Russia.
E-mail: [email protected]
Search for more papers by this authorVitaly A. Postoev
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Search for more papers by this authorAndrej M. Grjibovski
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan
North-Eastern Federal University, Yakutsk, Russia
Search for more papers by this authorAlexandra Krettek
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
Search for more papers by this authorEvert Nieboer
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorJon Øyvind Odland
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Search for more papers by this authorErik Eik Anda
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Search for more papers by this authorCorresponding Author
Anna A. Usynina
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Correspondence:
Anna A. Usynina, Northern State Medical University, 51, Troitsky Ave., Arkhangelsk 163000, Russia.
E-mail: [email protected]
Search for more papers by this authorVitaly A. Postoev
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Search for more papers by this authorAndrej M. Grjibovski
International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan
North-Eastern Federal University, Yakutsk, Russia
Search for more papers by this authorAlexandra Krettek
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
Search for more papers by this authorEvert Nieboer
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorJon Øyvind Odland
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Search for more papers by this authorErik Eik Anda
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Search for more papers by this authorAbstract
Background
Globally, about 11% of all liveborn infants are preterm. To date, data on prevalence and risk factors of preterm birth (PTB) in Russia are limited. The aims of this study were to estimate the prevalence of PTB in Murmansk County, Northwestern Russia and to investigate associations between PTB and selected maternal factors using the Murmansk County Birth Registry.
Methods
We conducted a registry-based study of 52 806 births (2006–2011). In total, 51 156 births were included in the prevalence analysis, of which 3546 were PTBs. Odds ratios with 95% confidence intervals of moderate-to-late PTB, very PTB and extremely PTB for a range of maternal characteristics were estimated using multinomial logistic regression, adjusting for potential confounders.
Results
The overall prevalence of PTB in Murmansk County was 6.9%. Unmarried status, prior PTBs, spontaneous and induced abortions were strongly associated with PTB at any gestational age. Maternal low educational level increased the risk of extremely and moderate-to-late PTB. Young (<18 years) or older (≥35 years) mothers, graduates of vocational schools, underweight, overweight/obese mothers, and smokers were at higher risk of moderate-to-late PTB. Secondary education, alcohol abuse, diabetes mellitus, or gestational diabetes were strongly associated with moderate-to-late and very PTB.
Conclusions
The observed prevalence of PTB (6.9%) in Murmansk County, Russia was comparable with data on live PTB from European countries. Adverse prior pregnancy outcomes, maternal low educational level, unmarried status, alcohol abuse, and diabetes mellitus or gestational diabetes were the most common risk factors for PTB.
References
- 1 WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstetricia et Gynecologica Scandinavica. 1977; 56: 247–253.
- 2Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379: 2162–2172.
- 3Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization 2010; 88: 31–38.
- 4 Euro-Peristat project with SCPE and Eurocat. European Perinatal health report. The health of pregnant women and babies in Europe in 2010. 2013. http://www.europeristat.com/ [last accessed 25 June 2015].
- 5Grjibovski AM, Bygren LO, Yngve A, Sjostrom M. Large social disparities in spontaneous preterm birth rates in transitional Russia. Public Health 2005; 119: 77–86.
- 6Anda EE, Nieboer E, Wilsgaard T, Kovalenko AA, Odland JO. Perinatal mortality in relation to birthweight and gestational age: a registry-based comparison of Northern Norway and Murmansk County, Russia. Paediatric and Perinatal Epidemiology 2011; 25: 218–227.
- 7Kozlovskaya A, Bojko E, Odland JO, Grjibovski AM. Secular trends in pregnancy outcomes in 1980–1999 in the Komi Republic, Russia. International Journal of Circumpolar Health 2007; 66: 437–448.
- 8Ancel PY, Goffinet F, Kuhn P, Langer B, Matis J, Hernandorena X, et al. Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatrics 2015; 169: 230–238.
- 9Locksmith G, Duff P. Infection, antibiotics, and preterm delivery. Seminars in Perinatology 2001; 25: 295–309.
- 10Mazor-Dray E, Levy A, Schlaeffer F, Sheiner E. Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome? The Journal of Maternal-Fetal & Neonatal Medicine 2009; 22: 124–128.
- 11Fraser AM, Brockert JE, Ward RH. Association of young maternal age with adverse reproductive outcomes. New England Journal of Medicine 1995; 332: 1113–1117.
- 12Nelson K, Lohsoonthorn V, Williams MA. Preterm delivery risk in relation to maternal occupational and leisure time physical activity among Thai women. Asian Biomedicine: Research, Reviews and News 2009; 3: 267–277.
- 13Albertsen K, Andersen A-MN, Olsen J, Grønbæk M. Alcohol consumption during pregnancy and the risk of preterm delivery. American Journal of Epidemiology 2004; 159: 155–161.
- 14Grillo E, Freitas PF. Smoking and other pre-gestational risk factors for spontaneous preterm birth. Revista Brasileira de Saúde Materno Infantil 2011; 11: 397–403.
10.1590/S1519-38292011000400006 Google Scholar
- 15Han Z, Mulla S, Beyene J, Liao G, McDonald SD. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. International Journal of Epidemiology 2011; 40: 65–101.
- 16Cnattingius S, Villamor E, Johansson S, Edstedt Bonamy AK, Persson M, Wikstrom AK, et al. Maternal obesity and risk of preterm delivery. Journal of the American Medical Association 2013; 309: 2362–2370.
- 17Mercer BM, Goldenberg RL, Moawad AH, Meis PJ, Iams JD, Das AF, et al. The preterm prediction study: effect of gestational age and cause of preterm birth on subsequent obstetric outcome. American Journal of Obstetrics and Gynecology 1999; 181: 1216–1221.
- 18McManemy J, Cooke E, Amon E, Leet T. Recurrence risk for preterm delivery. American Journal of Obstetrics and Gynecology 2007; 196: 576. e571-576; discussion 576. e576-577.
- 19Raisanen S, Gissler M, Saari J, Kramer M, Heinonen S. Contribution of risk factors to extremely, very and moderately preterm births – register-based analysis of 1,390,742 singleton births. PLoS ONE 2013; 8: e60660.
- 20Auger N, Le TU, Park AL, Luo ZC. Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study. BMC Pregnancy and Childbirth 2011; 11: 67.
- 21Henderson JJ, McWilliam OA, Newnham JP, Pennell CE. Preterm birth aetiology 2004-2008. Maternal factors associated with three phenotypes: spontaneous preterm labour, preterm pre-labour rupture of membranes and medically indicated preterm birth. The Journal of Maternal-Fetal and Neonatal Medicine 2012; 25: 642–647.
- 22Kozlovskaya A, Odland JØ, Grjibovski AM. Maternal occupation and marital status are associated with birth weight and risk of preterm birth in Monchegorsk (Murmansk Region) during a 30-year period. Human Ecology 2014; 8: 3–12. (in Russian).
- 23Sharashova EE, Anda EE, Grjibovski AM. Early pregnancy body mass index and spontaneous preterm birth in Northwest Russia: a registry-based study. BMC Pregnancy Childbirth 2014; 14: 303.
- 24Baranov E, Bugakova N, Gelvanovsky M, Gokhberg L, Dianov M, Elizarov V, et al. The Demographic Yearbook of Russia, 2013: Statistical Handbook. Moscow: Rosstat, 2014.
- 25Anda EE, Nieboer E, Voitov AV, Kovalenko AA, Lapina YM, Voitova EA, et al. Implementation, quality control and selected pregnancy outcomes of the Murmansk County Birth Registry in Russia. International Journal of Circumpolar Health 2008; 67: 318–334.
- 26Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstetrics and Gynecology 1996; 87: 163–168.
- 27Platt RW, Abrahamowicz M, Kramer MS, Joseph KS, Mery L, Blondel B, et al. Detecting and eliminating erroneous gestational ages: a normal mixture model. Statistics in Medicine 2001; 20: 3491–3503.
- 28Tukey J. Exploratory Data Analysis. Menlo Park, Cal., London, Amsterdam, Don Mills, Ontario, Sydney: Addison-Wesley, 1977.
- 29Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics 2013; 13: 59.
- 30 BMI Classification. Global Database on Body Mass Index. World Health Organization. 2006. Retrieved July 27, 2012.
- 31Raatikainen K, Heiskanen N, Heinonen S. Marriage still protects pregnancy. BJOG 2005; 112: 1411–1416.
- 32Counts ME, Morton MJ, Laffoon SW, Cox RH, Lipowicz PJ. Smoke composition and predicting relationships for international commercial cigarettes smoked with three machine-smoking conditions. Regulatory Toxicology and Pharmacology 2005; 41: 185–227.
- 33Ion R, Bernal AL. Smoking and preterm birth. Reproductive Sciences 2015; 22: 918–926.
- 34Hendler I, Goldenberg RL, Mercer BM, Iams JD, Meis PJ, Moawad AH, et al. The Preterm Prediction study: association between maternal body mass index and spontaneous and indicated preterm birth. American Journal of Obstetrics and Gynecology 2005; 192: 882–886.
- 35Fantuzzi G. Adipose tissue, adipokines, and inflammation. Journal of Allergy and Clinical Immunology 2005; 115: 911–919; quiz 920.
- 36Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. International Journal of Obesity and Related Metabolic Disorders 2001; 25: 1175–1182.
- 37Usha Kiran TS, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG 2005; 112: 768–772.
- 38Naeye RL. Maternal body weight and pregnancy outcome. The American Journal of Clinical Nutrition 1990; 52: 273–279.
- 39Goldenberg RL, Iams JD, Mercer BM, Meis PJ, Moawad AH, Copper RL, et al. The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. American Journal of Public Health 1998; 88: 233–238.
- 40Lepercq J, Coste J, Theau A, Dubois-Laforgue D, Timsit J. Factors associated with preterm delivery in women with type 1 diabetes: a cohort study. Diabetes Care 2004; 27: 2824–2828.
- 41Swingle HM, Colaizy TT, Zimmerman MB, Morriss FH Jr. Abortion and the risk of subsequent preterm birth: a systematic review with meta-analyses. Journal of Reproductive Medicine 2009; 54: 95–108.
- 42Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. New England Journal of Medicine 2000; 342: 1500–1507.
- 43Rasmussen SA, Moore CA, Paulozzi LJ, Rhodenhiser EP. Risk for birth defects among premature infants: a population-based study. Journal of Pediatrics 2001; 138: 668–673.
- 44Honein MA, Kirby RS, Meyer RE, Xing J, Skerrette NI, Yuskiv N, et al. The association between major birth defects and preterm birth. Maternal and Child Health Journal 2009; 13: 164–175.
- 45Fattah C, Farah N, Barry SC, O'Connor N, Stuart B, Turner MJ. Maternal weight and body composition in the first trimester of pregnancy. Acta Obstetricia et Gynecologica Scandinavica 2010; 89: 952–955.