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Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis

OBJECTIVE: To determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies. DESIGN: Systematic review and meta-analysis using random effects models. DATA SOURCES: An electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017)...

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Autores principales: Phillips, Courtney, Velji, Zain, Hanly, Ciara, Metcalfe, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734267/
https://www.ncbi.nlm.nih.gov/pubmed/28679674
http://dx.doi.org/10.1136/bmjopen-2016-015402
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author Phillips, Courtney
Velji, Zain
Hanly, Ciara
Metcalfe, Amy
author_facet Phillips, Courtney
Velji, Zain
Hanly, Ciara
Metcalfe, Amy
author_sort Phillips, Courtney
collection PubMed
description OBJECTIVE: To determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies. DESIGN: Systematic review and meta-analysis using random effects models. DATA SOURCES: An electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017) and ClinicalTrials.gov (completed studies effective 2017), supplemented by hand-searching bibliographies of included studies, to find all studies with original data concerning recurrent sPTB. STUDY ELIGIBILITY CRITERIA: Studies had to include women with at least one spontaneous preterm singleton live birth (<37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. The Newcastle-Ottawa Scale was used to assess study quality. RESULTS: Overall, 32 articles involving 55 197 women, met all inclusion criteria. Generally studies were well conducted and had a low risk of bias. The absolute risk of recurrent sPTB at <37 weeks’ gestation was 30% (95% CI 27% to 34%). The risk of recurrence due to preterm premature rupture of membranes (PPROM) at <37 weeks gestation was 7% (95% CI 6% to 9%), while the risk of recurrence due to preterm labour (PTL) at <37 weeks gestation was 23% (95% CI 13% to 33%). CONCLUSIONS: The risk of recurrent sPTB is high and is influenced by the underlying clinical pathway leading to the birth. This information is important for clinicians when discussing the recurrence risk of sPTB with their patients.
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spelling pubmed-57342672017-12-20 Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis Phillips, Courtney Velji, Zain Hanly, Ciara Metcalfe, Amy BMJ Open Obstetrics and Gynaecology OBJECTIVE: To determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies. DESIGN: Systematic review and meta-analysis using random effects models. DATA SOURCES: An electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017) and ClinicalTrials.gov (completed studies effective 2017), supplemented by hand-searching bibliographies of included studies, to find all studies with original data concerning recurrent sPTB. STUDY ELIGIBILITY CRITERIA: Studies had to include women with at least one spontaneous preterm singleton live birth (<37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. The Newcastle-Ottawa Scale was used to assess study quality. RESULTS: Overall, 32 articles involving 55 197 women, met all inclusion criteria. Generally studies were well conducted and had a low risk of bias. The absolute risk of recurrent sPTB at <37 weeks’ gestation was 30% (95% CI 27% to 34%). The risk of recurrence due to preterm premature rupture of membranes (PPROM) at <37 weeks gestation was 7% (95% CI 6% to 9%), while the risk of recurrence due to preterm labour (PTL) at <37 weeks gestation was 23% (95% CI 13% to 33%). CONCLUSIONS: The risk of recurrent sPTB is high and is influenced by the underlying clinical pathway leading to the birth. This information is important for clinicians when discussing the recurrence risk of sPTB with their patients. BMJ Publishing Group 2017-07-05 /pmc/articles/PMC5734267/ /pubmed/28679674 http://dx.doi.org/10.1136/bmjopen-2016-015402 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Obstetrics and Gynaecology
Phillips, Courtney
Velji, Zain
Hanly, Ciara
Metcalfe, Amy
Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title_full Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title_fullStr Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title_full_unstemmed Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title_short Risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
title_sort risk of recurrent spontaneous preterm birth: a systematic review and meta-analysis
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734267/
https://www.ncbi.nlm.nih.gov/pubmed/28679674
http://dx.doi.org/10.1136/bmjopen-2016-015402
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