Key result
Higher early-term birth rates linked to ~18% lower stillbirths, but more caesarean sections.
Why the study?
Optimal criteria for diagnosing pregnancy hypertension based on clinical factors correlating with poorest perinatal and long-term offspring outcomes were not established.
Observational
Yes
Absolute Event Rate: 1.05% vs 1.28%
Caution against increasing early-term births to lower stillbirth; leaves open whether associations reflect causation or confounding.
Data from 38,636 pregnant women were studied to determine the best criteria for diagnosing pregnancy hypertension based on the constellation of clinical factors yielding poorest perinatal and long-term results to the offspring. It was found that the combination of maximum diastolic blood pressure and maximum proteinuria, as observed during the interval 28 weeks to term, provided the closest correlation with outcome. This information offered an objective means for establishing a classification of hypertension-hypotension in late pregnancy.
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E. A. Friedman (1978) conducted an observational in Term pregnancies (≥ 37 weeks gestation). High early-term birth rate (> 27% of births between 37+0 and 38+6 weeks) vs. Low early-term birth rate (< 21% of births) was evaluated on Stillbirth rate per 1000 total births at ≥ 37 weeks. European countries with the highest proportion of early-term births had a lower pooled stillbirth rate (1.05 vs 1.28 per 1000 births) compared to those with the lowest proportion, but higher caesarean section rates and no differences in perinatal or neonatal mortality.
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