title: Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study.
abstract: OBJECTIVE
  The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes.
  
  
  METHODS
  A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI).
  
  
  RESULTS
  Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent's intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW.
  
  
  CONCLUSIONS
  Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.
authors.affiliation: Directorate of Research (Health Sciences), Manipal University, Manipal, India.
authors.forename: Chaitanya
authors.identifier: 0000-0002-0117-5369
authors.initials: C
authors.lastname: Tellapragada
authors.affiliation: Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Vandana Kalwaje
authors.identifier: 0000-0001-7561-4435
authors.initials: VK
authors.lastname: Eshwara
authors.affiliation: Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Manipal University, Manipal, India.
authors.forename: Parvati
authors.initials: P
authors.lastname: Bhat
authors.affiliation: Department of Community Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, India.
authors.forename: Shashidhar
authors.initials: S
authors.lastname: Acharya
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Asha
authors.initials: A
authors.lastname: Kamath
authors.affiliation: Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Manipal University, Manipal, India.
authors.forename: Shashikala
authors.initials: S
authors.lastname: Bhat
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Chythra
authors.initials: C
authors.lastname: Rao
authors.affiliation: Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Manipal University, Manipal, India.
authors.forename: Sathisha
authors.initials: S
authors.lastname: Nayak
authors.affiliation: Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Chiranjay
authors.initials: C
authors.lastname: Mukhopadhyay
mesh_terms: D000328:Adult; D044466:Asian People; D001827:Body Height; D016640:Diabetes, Gestational / Q000473:pathology; D005260:Female; D006761:Hospitals; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000473:pathology; D007194:India; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D016104:Oligohydramnios / Q000473:pathology; D010518:Periodontitis / Q000473:pathology; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Bacterial vaginosis; Bacteriuria; Intermediate vaginal flora; Low birth weight; Periodontitis; Premature birth