title: Pregnancy risk factors for very premature delivery: what role do hypertension, obesity and diabetes play?
abstract: OBJECTIVE
  Very premature delivery is a major cause of infant morbidity and mortality. Obesity, diabetes and pregnancy hypertension are known risk factors for pregnancy complications. The study aimed to scrutinize differences of pregnancy complications in a cohort of very premature deliveries compared to a national group.
  
  
  METHODS
  In a multicenter study performed between January 2009 and December 2010 including 1,577 very low birth weight (VLBW) infants, we compared parental reported pregnancy problems of VLBW infants with a national cohort (KIGGS). We compared reported pregnancy complications to reasons for premature delivery and neonatal outcome within the group of VLBW infants.
  
  
  RESULTS
  While parents of the national cohort reported pregnancy-induced hypertension in 8 %, parents of VLBW infants reported this complication more frequently (27 %). Mothers of the national cohort were significantly younger (1 year), suffered less from obesity, anaemia, diabetes. Regression analysis showed that hypertension (OR = 5.11) and advanced maternal age (OR = 1.03) increased the risk for premature birth. Women with hypertension were likely to experience a clinically indicated premature delivery, had more VLBW infants with a moderate growth restriction, but less multiples and their infants had less intraventricular haemorrhages grade 3 or 4. Otherwise, neonatal outcome was correlated with gestational age but not with the pregnancy complications diabetes, hypertension or obesity.
  
  
  CONCLUSIONS
  Premature birth seems to be correlated to gestational hypertension and associated problems in about ¼ of VLBW infants. Further studies should focus on preventing and treating gestational hypertension to avoid premature delivery and associated neonatal morbidity.
authors: Department of Pediatrics, University of Lübeck, Ratzeburger Allee 160, 23538 Lüebeck, Germany. uni@dr-spiegler.de
authors: Juliane
authors: J
authors: Spiegler
authors: G
authors: G
authors: Stichtenoth
authors: J
authors: J
authors: Weichert
authors: I R
authors: IR
authors: König
authors: M
authors: M
authors: Schlaud
authors: A
authors: A
authors: V D Wense
authors: D
authors: D
authors: Olbertz
authors: H
authors: H
authors: Gurth
authors: J-H
authors: JH
authors: Schiffmann
authors: B
authors: B
authors: Bohnhorst
authors: L
authors: L
authors: Gortner
authors: E
authors: E
authors: Herting
authors: W
authors: W
authors: Göpel
mesh_terms: D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors