Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Long-term trends in singleton preterm birth in South Australia from 1986 to 2014
Author: Verburg, P.
Dekker, G.
Venugopal, K.
Scheil, W.
Erwich, J.
Mol, B.
Roberts, C.
Citation: Obstetrics and Gynecology, 2018; 131(1):79-89
Publisher: Wolters Kluwer Health, Inc.
Issue Date: 2018
ISSN: 0029-7844
Statement of
Petra E. Verburg, Gus A. Dekker, Kamalesh Venugopal, Wendy Scheil, Jan Jaap H. M. Erwich, Ben W. Mol, and Claire T. Roberts
Abstract: OBJECTIVE: To describe long-term trends in the prevalence of preterm birth and rates of preterm birth in singleton pregnancies complicated by hypertensive disorders of pregnancy, small for gestational age (SGA), and preterm prelabor rupture of membranes (PROM) in South Australia. METHODS: We conducted a retrospective population study including all singleton live births in the state of South Australia from 1986 to 2014. Long-term trends for preterm birth, hypertensive disorders of pregnancy, SGA, preterm PROM as well as stillbirth were assessed using joinpoint regression analyses. Trends in maternal age, body mass index (BMI), ethnic diversity, parity, and smoking over time were also assessed. RESULTS: From 1986 to 2014, with a total of 539,234 singleton births, the overall preterm birth rates increased from 5.1% to 7.1% (P<.001) and for iatrogenic preterm birth increased from 1.6% to 3.2% (P<.001). The incidence of hypertensive disorders of pregnancy decreased from 8.7% to 7.2%. Among pregnancies complicated by hypertensive disorders of pregnancy, the proportion of preterm birth increased (10.4–17.5%, P<.001). The incidence of SGA decreased from 11.1% to 8.0%. Among pregnancies complicated by SGA, the proportion of preterm birth increased (2.9–5.4%, P<.001). The incidence of preterm PROM increased from 1.4% to 2.2%. Among pregnancies complicated by preterm PROM, the proportion of preterm birth remained stable. Preterm stillbirth rates declined (4.23–2.32%, P<.001). Maternal age, BMI, and ethnic diversity have all increased since 1986, whereas maternal smoking has decreased. CONCLUSION: In South Australia, the preterm birth rate among singletons increased from 1986 to 2014 by 40%, with iatrogenic preterm birth being responsible for 80% of this increase. Incidence of hypertensive disorders of pregnancy and SGA declined. Among pregnancies complicated by hypertensive disorders of pregnancy and SGA, the proportions of preterm birth increased, indicating earlier interventions in these women. The diagnosis of preterm PROM increased from 1% to 2%, and greater than 80% of preterm PROM was associated with preterm birth after 1990. Increasing iatrogenic delivery may be attributable, in part, to changing maternal phenotype and to altered clinicians' behavior. However, improvements in fetal surveillance, particularly ultrasonography, and advanced neonatal care may underpin perinatal clinical decision-making and the likelihood of iatrogenic birth.
Keywords: Humans
Hypertension, Pregnancy-Induced
Fetal Membranes, Premature Rupture
Premature Birth
Pregnancy Outcome
Population Surveillance
Birth Rate
Risk Assessment
Retrospective Studies
Cohort Studies
Maternal Age
Infant, Newborn
Infant, Small for Gestational Age
South Australia
Live Birth
Young Adult
Description: Presented at the Perinatal Society of Australia and New Zealand (PSANZ) Annual Congress, April 2–5, 2017, Canberra ACT, Australia.
Rights: © 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
DOI: 10.1097/AOG.0000000000002419
Grant ID:
Appears in Collections:Aurora harvest 8
Obstetrics and Gynaecology publications

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.