A multidisciplinary approach to the preterm birth
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.218
Abstract
Introduction. Rate of factors affecting preterm birth development has not been fully elucidated. The assessment was carried out by identifying 1-2 causes used to build up prognosis.
Aim: to identify most relevant risk factors for preterm birth and assess their impact on pregnancy.
Materials and Methods. The prospective comparative study was conducted that included group 1 - 36 women with term pregnancy, group 2 - 35 with preterm labor. Establishment of the menstrual cycle has been studied by assessing reproductive, somatic history, and course of current pregnancy.
Results. The postpartum women from group 2 were characterized by older age (30.42 ± 6.19 years; p = 0.038). The groups differed by the age of menarche: in group 2, its onset was recorded earlier (11.31 ± 0.79 years), showing shorter duration of menstruation (4.25 ± 1.26 days) as well as menstrual cycle (27.71 ± 3.46 days). Infections in puberty were substantially more frequent in postpartum women from group 2: group 2 vs. group 1 - in 21 vs. 8 postpartum women (p < 0.001); a history of urinary tract infections was also more common in group 2 (in 17 puerperas; p = 0.003), that is also typical for cases resulting in preterm pregnancy. The causative agent of bacterial vaginosis in group 2 was more often presented by Atopobium vaginae (in 17 puerperas; p = 0.0001), with Gardnerella vaginalis found less frequently (in 13 puerperas; p = 0.024), which is important to know for selecting proper therapy. During full-term pregnancy, the Lactobacillus crispatus strain, that determines vaginal health, was excreted significantly more often (in 29 puerperas; p = 0.009). Anemia affecting the antenatal fetal development and the course of labor was significantly more frequent in group 2 (in 22 puerperas; p < 0.001).
Conclusion. While planning pregnancy, it is necessary to take into account the age, menstrual cycle features, history of former infections, vaginal microbiota features, as well as conduct proper therapy and prevention in pregravid period.
About the Authors
M. D. Andreeva
Kuban State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Margarita D. Andreeva - MD, Dr Sci Med, Associate Professor, Professor, Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University.
4 Mitrofana Sedina Str., Krasnodar 350063.
Scopus Author ID: 57200068605.
R. A. Agajan
Kuban State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Rusan A. Agajan - MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University.
4 Mitrofana Sedina Str., Krasnodar 350063.
A. N. Akhidzhak
Kuban State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Asya N. Akhidzhak - MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University.
4 Mitrofana Sedina Str., Krasnodar 350063.
References
1. Delorme P., Goffinet F., Ancel P.-Y. et al. Cause of preterm birth as a prognostic factor for mortality. Obstet Gynecol. 2016;127(1):40-8. https://doi.org/10.1097/AOG.0000000000001179.
2. Mikhailova N.A., Voevodin D.A., Poddubikov A.V. Dysbiosis correction -the basis of regenerative medicine. [Korrekciya disbioza - osnova regenerativnoj mediciny]. Zhurnal mikrobiologii, epidemiologii i immunobiologii. 2018;(5):107-13. (In Russ.). https://doi.org/10.36233/0372-9311-2018-5-107-113.
3. Diemert A., Arck P.C. Preterm birth: pathogenesis and clinical consequences revisited. Semin Immunopathol. 2020;42:375-6. https://doi.org/10.1007/s00281-020-00809-w.
4. Preterm birth. World Health Organization, 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth.
5. Pizzella S., El Helou N., Chubiz J. et al. Evolving cervical imaging technologies to predict preterm birth. Semin Immunopathol. 2020;42(4):385-96. https://doi.org/10.1007/s00281-020-00800-5.
6. Menon R., Behnia F., Polettini J. et al. Novel pathways of inflammation in human fetal membranes associated with preterm birth and preterm pre-labor rupture of the membranes. Semin Immunopathol. 2020;42(4):431-50. https://doi.org/10.1007/s00281-020-00808-x.
7. Valenzuela I., van der Merwe J., De Catte L. et al. Foetal therapies and their influence on preterm birth. Semin Immunopathol. 2020;42(4):501-14. https://doi.org/10.1007/s00281-020-00811-2.
8. Bruno V., D'Orazio M., Ticconi C. et al. Machine Learning (ML) based-method applied in recurrent pregnancy loss (RPL) patients diagnostic work-up: a potential innovation in common clinical practice. Sci Rep. 2020;10(1):7970. https://doi.org/10.1038/s41598-020-64512-4.
9. Balaban D.V., Popp A., Radu F.I. et al. Hematologic manifestation in celiac disease - a practical review. Medicina (Kaunas). 2019;55(7):373. https://doi.org/10.3390/medicina55070373.
10. Karakhalis L.Yu., Ivantsiv N.S., Li N.V. Periodontal diseases and adverse pregnancy outcomes. [Bolezni periodonta v patogenezene blagopriyatnyh iskhodov beremennosti]. Doktor.Ru. 2021;20(1):21-5. (In Russ.). https://doi.org/10.31550/1727-2378-2021-20-1-21-25.
11. Khalafyan A.A. STATISTICA 6. Mathematical statistics with elements of probability theory. [STATISTICA 6. Matematicheskaya statistika s elementami teorii veroyatnostej]. Moscow: Binom, 2010. 491 p. (In Russ.).
12. Karakhalis L.Yu., Steblo E.I., Penzhoyan G.A. Reproductive health features of women with miscarriage, with overweight or obesity. [Osobennosti reproduktivnogo zdorov'ya pacientok s nevynashivaniem beremennosti, imeyushchih izbytochnuyu massu tela ili ozhirenie]. Akusherstvo i ginekologiya. Novosti. Mneniya. Obuchenie. 2019;7(2):31-7. (In Russ.). https://doi.org/10.24411/2303-9698-2019-12003.
13. Letter of the Ministry of Health of Russia dated December 17, 2013 No. 15-4/10/2-9480 "Premature birth". Clinical guidelines (treatment protocol). [Pis'mo Minzdrava Rossii ot 17 dekabrya 2013 g. №15-4/10/2-9480 «Prezhdevremennye rody». Klinicheskie rekomendacii (protokol lecheniya)]. Moscow, 2013. 20 р. (In Russ.). Available at: http://zdrav.spb.ru/media/komzdrav/documents/document/file/prezhdevremennie_rodi.pdf.
14. Pustotina O.A., Bubnova N.I., Ezhova L.S., Mladkovskaya T.B. Clinical and morphological characteristics of the fetoplacental complex in hydramnios and oligohydramnios. [Kliniko-morfologicheskaya harakteristika fetoplacentarnogo kompleksa pri mnogo- i malovodii infekcionnogo geneza]. Akusherstvo i ginekologiya. 2008;(2):19-21. (In Russ.).
15. Rukuni R., Bhattacharya S., Murphy M.F. et al. Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study. Acta Obstet Gynecol Scand. 2016;95(5):555-64. https://doi.org/10.1111/aogs.
16. Van Oostrum N., De Sutter P., Meys J., Verstraelen H. Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis. Hum Reprod. 2013;28(7):1809-15. https://doi.org/10.1093/humrep/det096.
17. Chen C., Song H., Wei W. et al. The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases. Nat Commun. 2017;8(1):875. https://doi.org/10.1038/s41467-017-00901-0.
18. Stone L. Infection: vaginal microbiota and infectious infertility. Nat Rev Urol. 2018;15(3):136. https://doi.org/10.1038/nrurol.2018.11.
19. Doerfiinger S.Y., Throop A.L., Herbst-Kralovetz M.M.Bacteria in the vaginal microbiome alter the innate immune response and barrier properties of the human vaginal epithelia in a species - specific manner. J Infect Dis. 2014;209(12):1989-99. https://doi.org/10.1093/infdis/jiu0046.
20. Karakhalis L.Yu., Ivantsiv N.S. Impact of vaginal microbiota on gestation and labour. [Vliyanie vlagalishchnoj mikrobioty na techenie beremennosti i rody]. Kubanskij nauchnyj medicinskij vestnik. 2020;27(6):30-43. (In Russ.). https://doi.org/10.25207/1608-6228-2020-27-6-30-43.
Review
For citations:
Andreeva M.D., Agajan R.A., Akhidzhak A.N. A multidisciplinary approach to the preterm birth. Obstetrics, Gynecology and Reproduction. 2021;15(4):351-359. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.218
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