Maternal factors associated with spontaneous preterm birth versus Caesarean born preterm [Factores maternos asociados con nacimiento pretérmino espontáneo versus pretérmino nacido por cesárea]

Abstract

Background: There are various causes of spontaneous preterm birth by Caesarean section. Objective: To identify maternal factors associated with spontaneous preterm labor versus cesarean birth. Patients and methods: cross sectional study that included 859 preterm births only treated between September 2004 and August 2005. The gestational age of 20 to 36 weeks by date of last menstrual period was confirmed by assessments of Capurro and Ballard. The information was collected prospectively through direct interview and clinical records. The association was measured by logistic regression. Results: 14.882 births, 859 were preterm (5.8%) spontaneous preterm births were 489 (57%) and 368 by cesarean (43%). In the bivariate analysis were associated with spontaneous preterm: poor prenatal care (OR: 2.03, 95% CI 1.54-2.69) and mother under 20 years (OR: 1.85, 95% CI 1.34-2.56) for preterm birth by Cesarean urinary tract infection (OR: 1.49, 95% CI 1.08-2.06) and premature rupture of amniotic membranes more than 24 hours (OR: 1.75, 95% CI 1.23-2.50). In the multivariate analysis were associated with spontaneous preterm birth, history of spontaneous preterm and poor prenatal care, factors associated with preterm birth by cesarean lost statistical significance. Conclusion: a history of prior spontaneous preterm birth, poor prenatal care and mother under 20 years were predictors of spontaneous preterm birth in a multivariate model.