Pregnancy disorders leading to very preterm birth influence neonatal outcomes: Results of the population-based ACTION cohort study

Luigi Gagliardi, Franca Rusconi, Monica Da Frè, Giorgio Mello, Virgilio Carnielli, Domenico Di Lallo, Francesco Macagno, Silvana Miniaci, Carlo Corchia, Marina Cuttini

Research output: Contribution to journalArticle

Abstract

Background:We examined the relationships between pregnancy disorders leading to very preterm birth (spontaneous preterm labor, prelabor premature rupture of membranes (PPROM), hypertension/preeclampsia, intrauterine growth restriction (IUGR), antenatal hemorrhage, and maternal infection), both in isolation and grouped together as "disorders of placentation" (hypertensive disorders and IUGR) vs. "presumed infection/ inflammation" (all the others), and several unfavorable neonatal outcomes.Methods:We examined a population-based prospective cohort of 2,085 singleton infants of 23-31 wk gestational age (GA) born in six Italian regions (the Accesso alle Cure e Terapie Intensive Ostetriche e Neonatali (ACTION) study).Results:Neonates born following disorders of placentation had a higher GA and better overall outcomes than those born following infection/inflammation. After adjustment for GA, however, they showed higher risk of mortality (odds ratio, OR: 1.4; 95% confidence interval, CI: 1.0-2.0), bronchopulmonary dysplasia (BPD) (OR: 2.5; CI: 1.8-3.6), and retinopathy of prematurity (ROP) (OR: 2.0; CI: 1.1-3.5), especially in growth-restricted infants, and a lower risk of intraventricular hemorrhage (IVH) (OR: 0.5; CI: 0.3-0.8) and periventricular leukomalacia (PVL) (OR: 0.6; CI: 0.4-1.1) as compared with infants born following infection/inflammation disorders.Conclusion:Our data confirm the hypothesis that, in very preterm infants, adverse outcomes are both a function of immaturity (low GA) and of complications leading to preterm birth. The profile of risk is different in different pregnancy disorders.

Original languageEnglish
Pages (from-to)794-801
Number of pages8
JournalPediatric Research
Volume73
Issue number6
DOIs
Publication statusPublished - Jun 2013

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Premature Birth
Gestational Age
Cohort Studies
Placentation
Pregnancy
Infection
Inflammation
Population
Growth Disorders
Periventricular Leukomalacia
Hemorrhage
Bronchopulmonary Dysplasia
Retinopathy of Prematurity
Premature Obstetric Labor
Growth
Pre-Eclampsia
Premature Infants
Rupture
Odds Ratio
Mothers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Pregnancy disorders leading to very preterm birth influence neonatal outcomes : Results of the population-based ACTION cohort study. / Gagliardi, Luigi; Rusconi, Franca; Da Frè, Monica; Mello, Giorgio; Carnielli, Virgilio; Di Lallo, Domenico; Macagno, Francesco; Miniaci, Silvana; Corchia, Carlo; Cuttini, Marina.

In: Pediatric Research, Vol. 73, No. 6, 06.2013, p. 794-801.

Research output: Contribution to journalArticle

Gagliardi, L, Rusconi, F, Da Frè, M, Mello, G, Carnielli, V, Di Lallo, D, Macagno, F, Miniaci, S, Corchia, C & Cuttini, M 2013, 'Pregnancy disorders leading to very preterm birth influence neonatal outcomes: Results of the population-based ACTION cohort study', Pediatric Research, vol. 73, no. 6, pp. 794-801. https://doi.org/10.1038/pr.2013.52
Gagliardi, Luigi ; Rusconi, Franca ; Da Frè, Monica ; Mello, Giorgio ; Carnielli, Virgilio ; Di Lallo, Domenico ; Macagno, Francesco ; Miniaci, Silvana ; Corchia, Carlo ; Cuttini, Marina. / Pregnancy disorders leading to very preterm birth influence neonatal outcomes : Results of the population-based ACTION cohort study. In: Pediatric Research. 2013 ; Vol. 73, No. 6. pp. 794-801.
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AU - Gagliardi, Luigi

AU - Rusconi, Franca

AU - Da Frè, Monica

AU - Mello, Giorgio

AU - Carnielli, Virgilio

AU - Di Lallo, Domenico

AU - Macagno, Francesco

AU - Miniaci, Silvana

AU - Corchia, Carlo

AU - Cuttini, Marina

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