Preterm birth: current opportunities for prediction аnd prevention

BACKGROUND: The need for resuscitation at birth depends on the gestational age — the shorter the gestational age, the more often resuscitation is required.

AIM: to determine risk factors and possible methods for preventing preterm birth.

MATERIALS AND METHODS: A retrospective analysis of medical documentation data was carried out on 12,342 women whose delivery was carried out at the Perinatal Center of the Pediatric University. The main group included 680 patients whose pregnancy ended with delivery at 22 weeks — 36 weeks 6 days, the control group included 11,662 patients whose pregnancy ended with term birth.

RESULTS: When analyzing anamnestic factors, it was found that the age of the patients at the time of registration for pregnancy in the main group was statistically significantly higher, height was statistically significantly lower, the serial number of both pregnancy and childbirth was statistically significantly higher, VI or more pregnancies, IV or more births, obesity, arterial hypertension, and a burdened obstetric history (miscarriage, premature birth) are statistically significantly more common than in the control group. In the main group of symptoms, the following are most often noted: pregnancy resulting from the use of assisted reproductive technologies, moderate and severe preeclampsia, isthmic-cervical insufficiency, abnormal indicators of the umbilical cord artery, breech presentation of the fetus. Meconium staining of amniotic fluid was 2 times more common in full-term pregnancies.

CONCLUSIONS: Ascending infection of the placenta, mycoplasma, herpetic and chlamydial choriodeciditis, sub- and decompensated chronic placental insufficiency were statistically significantly more common in premature births. Based on discriminant analysis, a model for predicting the risk of preterm birth was built.