Association of chronic medical conditions with preterm labor

Bahareh Derakhshi, Nader Esmailnasab

DOI: 10.22122/cdj.v2i1.77


BACKGROUND: Prematurity is the most common cause of neonatal death and according to Millennium Development Goal (MDG), two-thirds of all under-five deaths should be reduced by 2015. Therefore, this study examined factors related to preterm birth in Sanandaj, Iran in 2012.

METHODS: This case-control study has been conducted on 600 pregnant women; cases were 200 women with preterm labor and controls were 400 women with term labor, in Be’sat Hospital, Sanandaj, Iran, in 2012. Results were analyzed by Chi-square, Mann-Whitney U and logistic regression tests.

RESULTS: In univariate analysis, overt diabetes (P = 0.030), chronic hypertension (P < 0.001), preeclampsia and eclampsia (P < 0.001), had significant correlations with preterm labor. However, multivariate analysis results showed that factors like preeclampsia and eclampsia (P < 0.001) and chronic hypertension (P = 0.030) had significant correlation with the incidence of premature birth. In univariate and multivariate analysis, anemia
(P = 0.340) had not any association with the preterm labor.

CONCLUSION: The results of this study showed some chronic maternal conditions such as chronic hypertension and diabetes mellitus, which are important pre-existing medical disorder complicating pregnancy and control of blood pressure and blood sugar before pregnancy, and have an important effect in decreased of preterm labor and complications. But others such as mother’s anemia were not responsible for the prematurity.


Prematurity, Diabetes, High Risk Mothers, Hypertension

Full Text:



Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365(9455): 217-23.

Leeman L, Fontaine P. Hypertensive disorders of pregnancy. Am Fam Physician 2008; 78(1): 93-100.

Ashton DM, Lawrence HC, Adams NL, Fleischman AR. Surgeon General's Conference on the Prevention of Preterm Birth. Obstet Gynecol. 2009; 113(4): 925-30.

Chandra Dey A, Mannan A, Saha L, Hossain I, Shahidullah M. Magnitude of Problems of Prematurity- National and Global Perspective: A Review. Bangladesh J Child Health 2012; 36 (3): 146-52.

Sepanlou SG, Kamangar F, Poustchi H, Malekzadeh R. Reducing the burden of chronic diseases: a neglected agenda in Iranian health care system, requiring a plan for action. Arch Iran Med 2010; 13(4): 340-50.

Haghdoost AA, Mirzazadeh A. Familial Aggregation of Coronary Heart Disease Risk Factors in Kerman Province. Iran J Epidemiol 2006; 1(3): 7-12.

Gilbert WM, Young AL, Danielsen B. Pregnancy outcomes in women with chronic hypertension: a population-based study. J Reprod Med 2007; 52(11): 1046-51.

Reece A, Homko CJ. Diabets mellitus and pregnancy. In: Gibbs RS, Editor. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008. p. 246-56.

Watchko JF. Seminars in fetal and neonatal medicine "continuing controversies in perinatal jaundice". Semin Fetal Neonatal Med 2010; 15(3): 121.

Azizi F, Janghorbani M, Hatami H, Azizi T, Agha Abbasloo M. Nourologic system of disease. In: Azizi F, Janghorbani M, Hatami H, Azizi T, Agha Abbasloo M, Editors. Epidemiology and control of common disease in Iran. Tehran, Iran: Khosravi Publication; 2010. p. 195-202. [In Persian].

Khader Y, Al-shishani L, Obeidat B, Khassawneh M, Burgan S, Amarin ZO, et al. Maternal periodontal status and preterm low birth weight delivery: a case-control study. Arch Gynecol Obstet 2009; 279(2): 165-9.

Boots AB, Sanchez-Ramos L, Bowers DM, Kaunitz AM, Zamora J, Schlattmann P. The short-term prediction of preterm birth: a systematic review and diagnostic metaanalysis. Am J Obstet Gynecol 2014; 210(1): 54.

Sibai BM, Caritis SN, Hauth JC, MacPherson C, VanDorsten JP, Klebanoff M, et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National institute of Child health and Human Development Maternal- Fetal Medicine Units Network. Am J Obstet Gynecol 2000; 183(6): 1520-4.

Kramer MS, Goulet L, Lydon J, Seguin L, McNamara H, Dassa C, et al. Socio-economic disparities in preterm birth: causal pathways and mechanisms. Paediatr Perinat Epidemiol 2001; 15(Suppl 2): 104-23.

Mercer BM, Goldenberg RL, Das A, Moawad AH, Iams JD, Meis PJ, et al. The preterm prediction study: a clinical risk assessment system. Am J Obstet Gynecol 1996; 174(6): 1885-93.

Esmailnasab N, Afkhamzadeh AB, Biglari F. Study of epidemiologic survey of perinatal mortality in Kurdistan [Thesis]. Sanandaj, Iran: School of Medicine, Kurdistan University of Medical Science; 2011. [In Persian].

Wagner SJ, Barac S, Garovic VD. Hypertensive pregnancy disorders: current concepts. J Clin Hypertens (Greenwich) 2007; 9(7): 560-6.

Lindheimer MD, Conrad KP, Karumanchi SA. Renal Physiology and Disease in Pregnancy. In: Alpern RJ, Hebert SC, Editors. Seldin and Giebisch's The Kidney: Physiology & Pathophysiology. 4th ed. New York, NY: Academic Press; 2007. p. 2339-98.

Xiong X, Mayes D, Demianczuk N, Olson DM, Davidge ST, Newburn-Cook C, et al. Impact of pregnancy-induced hypertension on fetal growth. Am J Obstet Gynecol 1999; 180(1 Pt 1): 207-13.

Meis PJ, Michielutte R, Peters TJ, Wells HB, Sands RE, Coles EC, et al. Factors associated with preterm birth in Cardiff, Wales. I. Univariable and multivariable analysis. Am J Obstet Gynecol 1995; 173(2): 590-6.

Mohsenzadeh A, Saket S, Karimi A. Prevalence of preterm neonates and risk factors. Iran J neonatal 2011; 2(2): 38-42.

Kang JH, Lin HC. Stroke during pregnancy: no increased risk of preterm delivery and low birth weight, a nationwide case-controlled study. J Neurol Neurosurg Psychiatry 2010; 81(11): 1211-4.

Bora R, Sable C, Wolfson J, Boro K, Rao R. Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India. J Matern Fetal Neonatal Med 2013.

Ebrahimi S, Haghbin S, Poor Mahmoodi A. Incidence and etiologic factors of prematurity. Armaghane-danesh 2000; 5(19-20): 41-35. [In Persian].

Afrakhteh M, Ebrahimi S, Valaei N. Prevalence of preterm delivery and its related factors in females referring to Shohada Tajrish Hospital, 1995-99. Pejouhandeh 2003; 7(4): 341-4. [In Persian].

Al-Dabbagh SA, Al-Taee WY. Risk factors for pre-term birth in Iraq: a case-control study. BMC Pregnancy Childbirth 2006; 6: 13.

Jolley JA, Kim S, Wing DA. Acute pyelonephritis and associated complications during pregnancy in 2006 in US hospitals. J Matern Fetal Neonatal Med 2012; 25(12): 2494-8.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.