Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review

B. M. Kazemier, P. E. Buijs, L. Mignini, J. Limpens, C. J.M. de Groot, B. W.J. Mol, EBM CONNECT

Research output: Contribution to journalReview article

40 Citations (Scopus)

Abstract

BACKGROUND: Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered.

OBJECTIVES: To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies.

SEARCH STRATEGY: An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies.

AUTHOR'S CONCLUSIONS: The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton.

SELECTION CRITERIA: Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy.

DATA COLLECTION AND ANALYSIS: The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method.

MAIN RESULTS: We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6).

LanguageEnglish
JournalBJOG : an international journal of obstetrics and gynaecology
Volume121
Issue number10
DOIs
Publication statusPublished - 1 Sep 2014
Externally publishedYes

Keywords

  • Recurrence
  • singleton
  • spontaneous preterm birth
  • twin

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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