Premature births have increased significantly although survival rates of babies born early have improved dramatically, a study shows.
The risk of neonatal death from premature birth more than halved during a 25 year period and there has also been a 10 per cent reduction in stillbirth associated with pre-term births.
The University of Edinburgh research analysed data relating to nearly 90,000 births in Scotland between 1980 and 2005.
Researchers hope that better understanding of the trends and causes behind premature births will help to develop better treatments for expectant mothers.
The number of babies born prematurely increased from 54 per 1,000 births between 1980 and 1985 to 63 per 1,000 births between 2000 and 2005.
Improvements in the survival rates of premature babies were greater when births were medically induced or by pre-planned Caesarean section compared with pre-term births in which labour occurred naturally.
The findings support the shift towards more medically induced early births, with these preterm deliveries up more than 40 per cent compared with a 10 per cent increase in early births from natural onset of labour.
The research, published in the journal PLoS Medicine, also found the growing number of expectant mothers with diabetes had resulted in an increase in the numbers of babies born prematurely.
Researchers found a seven-fold increase in premature births where the mothers were diabetic before becoming pregnant. Premature births linked to gestational diabetes, where expectant mothers develop diabetes during pregnancy, also increased four-fold over the study period.
High blood pressure in expectant mothers, however, remained the major factor linked to pre-term births – although the proportion of babies born prematurely as a result of this condition decreased over the 25-year study period.
A rise in the average age of women becoming pregnant was not found to have affected the incidence of premature births.
Professor Jane Norman, Director of the Tommy’s Centre for Maternal and Fetal Health Research at the University of Edinburgh, said: “The increase in survival rates for babies born prematurely backs up decisions by doctors to medically induce births to prevent potential complications. The increase in diabetes as a factor in premature births is also interesting and may be because there are more women with pre-existing diabetes – which is linked to obesity – as well as better diagnosis of expectant mothers with gestational diabetes.”
The study was carried out in collaboration with Information Services Division and NHS Scotland and funded by the Chief Scientist Office, Scottish Government and the charity Tommy’s.
Premature births are linked to more than 66 per cent of single baby still births, 65 per cent of single baby neonatal deaths and 67 per cent of infants who have a prolonged stay in the neonatal unit.
- Norman JE, Morris C, Chalmers J. The Effect of Changing Patterns of Obstetric Care in Scotland (1980-2004) on Rates of Preterm Birth and Its Neonatal Consequences: Perinatal Database Study. PLoS Med, 2009; 6 (9): e1000153 DOI: 10.1371/journal.pmed.1000153
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