Women born prematurely have increased risk of pregnancy complications

Robin Wulffson MD's picture
pregnancy, preterm birth, prematurity, complications
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According to a new study, women who were born prematurely have a significantly increased risk of pregnancy complications. The study was published online on September 24 in the Canadian Medical Association Journal (CMAJ) by researchers affiliated with the University of Montréal, (Montréal, Quebec); and Laval University (Québec, Quebec).

The study authors noted that adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can result from intrauterine growth restriction, preterm birth, or both.

The researchers designed their study to examine the relationship between preterm birth and pregnancy complications later in life. The study group comprised 7,405 women who were born prematurely in the province of Quebec involving 7,405 women born preterm. Of the study group, 554 were born before 32 weeks’ gestation and 6,851 were born at 32–36 weeks’ gestation. The study group was compared to a matched cohort of 16,714 born at term between 1976 and 1995 who had a live birth or stillbirth between 1987 and 2008. The primary outcome measures were pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia or eclampsia).

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The researchers found that overall, 19.9% of women born at less than 32 weeks, 13.2% born at 32–36 weeks, and 11.7% born at term had at least one pregnancy complication at least once during the study period. Women born small for gestational age (both term and preterm) had increased odds of having at least one pregnancy complication compared with women born at term and appropriate for gestational age. After adjustment for various factors, including birth weight for gestational age, the odds of pregnancy complications associated with preterm birth was elevated by 1.95-fold among women born before 32 weeks' gestation and 1.14-fold among those born at 32–36 weeks' gestation relative to women born at term.

The authors acknowledge that women who are born preterm may have undiagnosed risk factors for the pregnancy complications. In addition, they theorized that there may be a potential hereditary component to pregnancy complications that was not accounted for in the study. The also theorized that poor perinatal health may permanently alter cardiovascular and metabolic development and function; however, they added that this process is poorly understood. With today’s technology, infants born before 32 weeks’ gestation survive; therefore, this can result in a larger population at risk for pregnancy-related hypertension, type 2 diabetes, and other health issues.

The authors concluded that being born preterm, in addition to, and independent of, being small for gestational age, was associated with a significantly increased risk of later having pregnancy complications.

Take home message:
If you were born prematurely, it is a part of your medical history. However, if you were a “premie” you can increase the chances of a good pregnancy outcome by practicing a healthy lifestyle before—and during—your pregnancy. It would also be prudent to seek obstetrical care from a board-certified obstetrician rather than a midwife and deliver at a tertiary medical center—one that can provide a high level of care for both you and your infant.

Reference: Canadian Medical Association Journal

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