Risk factors for preterm labor: An Umbrella Review of meta-analyses of observational studies.
Ioannis MitrogiannisEvangelos EvangelouAthina EfthymiouTheofilos KanavosEffrosyni BirbasGeorge MakrydimasStefania PapatheodorouPublished in: Research square (2023)
Preterm birth defined as delivery before 37 gestational weeks, is a leading cause of neonatal and infant morbidity and mortality. Understanding its multifactorial nature may improve prediction, prevention and the clinical management. We performed an umbrella review to summarize the evidence from meta-analyses of observational studies on risks factors associated with PTB, evaluate whether there are indications of biases in this literature and identify which of the previously reported associations are supported by robust evidence. We included 1511 primary studies providing data on 170 associations, covering a wide range of comorbid diseases, obstetric and medical history, drugs, exposure to environmental agents, infections and vaccines. Only seven risk factors provided robust evidence. The results from synthesis of observational studies suggests that sleep quality and mental health, risk factors with robust evidence should be routinely screened in clinical practice, should be tested in large randomized trial. Identification of risk factors with robust evidence will promote the development and training of prediction models that could improve public health, in a way that offers new perspectives in health professionals.
Keyphrases
- meta analyses
- risk factors
- preterm birth
- systematic review
- public health
- mental health
- sleep quality
- gestational age
- clinical practice
- randomized controlled trial
- pregnant women
- healthcare
- low birth weight
- depressive symptoms
- physical activity
- human health
- machine learning
- weight gain
- risk assessment
- big data
- birth weight
- body mass index