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PubMed2004

Heterogeneity of perinatal outcomes in the preterm delivery syndrome.

OBJECTIVE: Our aim was to document the differential neonatal morbidity and intrapartum and neonatal mortality of subgroups of preterm delivery. METHODS: This analysis included 38,319 singleton pregnancies, of which 3,304 (8.6%) were preterm deliveries (less than 37 completed weeks) enrolled in the World Health Organization randomized trial of a new antenatal care model. We classified them as preterm deliveries after spontaneous initiation of labor, either with or without maternal obstetric and medical complications; preterm deliveries after prelabor spontaneous rupture of amniotic membranes (PROM), either with or without obstetric and medical complications; and medically indicated preterm deliveries with maternal obstetric and medical complications. Severe neonatal morbidity and neonatal mortality were the primary outcomes. RESULTS: Fifty-six percent of all preterm deliveries were spontaneous, without maternal complications. Small for gestational age was increased only among the medically indicated preterm delivery group (22.3%). Very early preterm delivery (less than 32 weeks of gestation) was highest among PROM with complications (37%). For intrapartum fetal death and neonatal death, after adjusting by gestational age and other confounding variables, we found that the obstetric and medical complications preceding preterm delivery predicted the different risk levels. Conversely, for severe neonatal morbidity the clinical presentation, ie, PROM or medically indicated, predicted the increased risk. CONCLUSION: There are differential neonatal outcomes among preterm deliveries according to clinical presentation, pregnancy complications, gestational age at delivery, and its association with small for gestational age. This syndromic nature of the condition should be considered if preterm delivery is to be fully understood and thus reduced.

Adolescent↗
PubMed1985

Sialic acid in newborn and maternal lymphocytes: preterm deliveries.

Sialic acid was determined in newborn and maternal lymphocytes immediately after preterm deliveries of 34 and 35 weeks of gestation. The results were compared with those found in full-term deliveries. In contrast with full-term deliveries, in preterm deliveries a significant increase in sialic acid in maternal as compared to newborn lymphocytes was found. However, the mean cumulative value of sialic acid for maternal and newborn lymphocytes was similar in both groups. In addition to this, sialic acid concentrations seem to be sex-dependent and higher mean cumulative values for maternal and newborn lymphocytes could be found for male as compared to female newborns after full- as well as after preterm deliveries.

Female↗
PubMed2003

Genetic amniocentesis: a risk factor for preterm delivery?

OBJECTIVE: To determine whether genetic amniocentesis performed in the second trimester of pregnancy is associated with the risk of preterm delivery. STUDY DESIGN: Case-control study performed in several departments of obstetrics and gynaecology of nine European countries. Three thousand and ninety-one preterm births and 5298 controls randomly selected from singleton births born at term during 1994-1997 were analysed. Logistic regression models were used to compare preterm births altogether and, separately, spontaneous preterm delivery and induced preterm delivery. RESULTS: An increased risk of preterm delivery was found in women having second trimester genetic amniocentesis after taking account of other risk factors and confounding variables (odds ratios (OR)=1.59, 95% confidence intervals (95% CI): 1.31-1.92). The association was statistically significant and similar for spontaneous preterm delivery and induced preterm delivery. CONCLUSION: The study shows an association between preterm delivery and genetic amniocentesis. In view of the wide use of amniocentesis, further research on the etiologic role of this prenatal diagnostic technique is needed.

Adult↗
PubMed2002

A prospective study of vaginal pH as a predictor of preterm delivery.

OBJECTIVE: To test the usefulness of vaginal pH determinations in the prediction of the risk of preterm delivery at or before 36 weeks of gestation. METHODS: This was a prospective study of asymptomatic pregnant women. Vaginal pH was determined using pH paper in a sterile speculum examination during prenatal visits. Patients were followed to delivery and hospital records were reviewed to extract obstetric information. A total of 308 women agreed to participate and met the criteria for enrolment. Preterm delivery was defined as delivery at or prior to 36 weeks of gestation. Abnormal pH was defined as a pH of > 5.0. RESULTS: Abnormal vaginal pH was associated with increased risk of preterm delivery, (OR 3.3, 95% CI 1.15, 9.2; p = 0.02). In the first trimester, an abnormal vaginal pH was not associated with preterm delivery (p = 0.3). After the first trimester, a vaginal pH of 5.0 or greater was associated with increased risk of preterm delivery (OR 9.6, 95% CI 2.0, 45.5; p = 0.001) as well as delivering an infant of less than 2500 g (OR 3.1, 95% CI 1.2, 7.8; p = 0.015). History of a previous preterm delivery was associated with increased risk of preterm delivery (OR 6.2, 95% CI 1.6, 23.7; p = 0.02). A logistic regression model used to control for a history of preterm delivery and race showed abnormal vaginal pH to remain as an independent predictor of preterm delivery (p = 0.01). CONCLUSIONS: High vaginal pH (> or = 5.0) identified women at risk for preterm delivery.

Adult↗
PubMed2005

Fetal growth rates and the very preterm delivery of twins.

OBJECTIVE: Our objective was to determine whether slow fetal growth rates and twin growth patterns from 20 weeks' gestation to delivery are associated with very preterm delivery. STUDY DESIGN: Available charts were reviewed for twin pregnancies, delivered between 1979 and 2002, at 4 U.S. medical centers. The sample of 1612 pregnancies delivered at 28 week's gestation or greater and had at least 2 ultrasound evaluations of fetal size from 20 to 28 weeks or from 28 weeks to delivery for estimation of fetal growth rates (grams per week). Slow fetal growth (below the 10th percentile) was defined as less than 90 grams per week at 20-28 weeks and 168 g/week from 28 weeks to delivery. The main outcome measure was the timing of delivery. RESULTS: Of the women delivering twins, 5.3% delivered extremely preterm (28-30 weeks), 8.5% very preterm (31-32 weeks), and 40.1% preterm (33-36 weeks). Patterns of growth for the pair were highly associated with very preterm delivery. Compared with neither growing slowly (1.7%), 4.9% delivered very preterm if only 1 twin grew slowly. Very preterm was 14.6% (adjusted odds ratio 9.81; 95% confidence interval, 3.50-27.48) with both growing slowly from 28 weeks on and 20.0% (adjusted odds ratio 15.04; 95% confidence interval 5.13-44.11) with both growing slowly over both intervals. Survival analyses indicated that twins with normal growth in both intervals remained undelivered for a significantly longer number of days (P < .0001) than pairs in which one or both twins were growing slowly. CONCLUSION: Very preterm delivery of twins seems to be preceded by slowed or compromised fetal growth for the pair.

Diseases in Twins↗
PubMed2005

Plasma C-reactive protein in early pregnancy and preterm delivery.

Systemic maternal infections have been associated with preterm delivery. The authors examined the association of C-reactive protein (CRP), a marker of inflammation, with preterm delivery. This nested case-control study was conducted within Project Viva in Massachusetts between 1999 and 2002. Subjects were 117 women who delivered preterm (< 37 weeks' gestation) and 117 controls (term deliveries) matched on age, race/ethnicity, and smoking status. High-sensitivity CRP assays were performed on early-pregnancy (5.3-19.3 weeks' gestation) plasma samples. Odds ratios and 95% confidence intervals were estimated by using conditional logistic regression adjusted for matching factors, gestational age at blood collection, and prepregnancy body mass index. Median concentration of CRP was 3.2 mg/liter in cases versus 2.4 mg/liter in controls. No significant association was found between quartiles of CRP and preterm delivery. However, CRP levels exceeding the threshold defined in the literature were associated with increased risk of preterm delivery (odds ratio = 2.55, 95% confidence interval: 1.05, 6.02 for CRP > or = 8 mg/liter). The association was stronger among cases who experienced spontaneous delivery (odds ratio = 4.64, 95% confidence interval: 0.94, 22.96) versus indicated delivery (odds ratio = 1.42, 95% confidence interval: 0.44, 4.61). These findings suggest that very high CRP levels in early pregnancy are associated with preterm delivery.

Alcohol Drinking↗
PubMed2000

Defining preterm delivery--the epidemiology of clinical presentation.

It is possible that preterm delivery is not a single entity but a cluster of conditions with different aetiologies that ultimately result in the delivery of an infant before 37 completed weeks of gestation. Whereas some researchers have reported aetiological heterogeneity, others have found no differences between subtypes or have disputed the desirability and utility of classifying preterm birth into subtypes. This study explores the relationship of maternal risk factors to type of preterm delivery in a cohort of over 7000 black and white women delivering singleton infants at the University of California, San Francisco's Moffitt Hospital between 1980 and 1990. Although the magnitude of the effect of individual risk factors differed between preterm delivery subtypes, the set of risk factors significantly associated with both categories of spontaneous preterm delivery was identical, while that associated with medically indicated preterm births was different. This study indicates that whereas the distinction between spontaneous preterm deliveries and those that are medically indicated seems valid, distinguishing between types of spontaneous preterm births may not lead to useful aetiological inferences.

Adolescent↗
PubMed2001

Infection, antibiotics, and preterm delivery.

The relationship between genital tract infection and preterm delivery has been established on the basis of biochemical, microbiological, and clinical evidence. In theory, pathogenic bacteria may ascend from the lower reproductive tract into the uterus, and the resulting inflammation leads to preterm labor, rupture of the membranes, and birth. A growing body of evidence suggests that preterm labor and/rupture of the membranes are triggered by micro-organisms in the genital tract and by the host response to these organisms, ie, elaboration of cytokines and proteolytic enzymes. Epidemiologic and in vitro studies do not prove a cause-and-effect relationship between infection and preterm birth. However, the preponderance of evidence indicates that treatment of asymptomatic bacteriuria and symptomatic lower genital tract infections such as bacterial vaginosis (BV), trichomoniasis, gonorrhea, and chlamydia will lower the risk of preterm delivery. Based on current evidence, pregnant women who note an abnormal vaginal discharge should be tested for BV, trichomonas, gonorrhea, and chlamydia. Those who test positive should be treated appropriately. A 3- to 7-day course of antibiotic treatment for asymptomatic bacteriuria during pregnancy is clinically indicated to reduce the risk of pyelonephritis and preterm delivery. Routine screening for chlamydia and gonorrhea should be performed for women at high risk of acquiring sexually transmitted diseases. The practice of routine screening for BV in asymptomatic women who are at low risk for preterm delivery cannot be supported based on evidence from the literature. Routine screening for asymptomatic bacteriuria during pregnancy is cost-effective, particularly in high-prevalence populations. The results of antibiotic trials for the treatment of preterm labor have been inconsistent. In the absence of reasonable evidence that antimicrobial therapy leads to significant prolongation of pregnancy in the setting of preterm labor, antibiotics should be used only for protecting the neonate from group B streptococci sepsis. They should not be used for the purpose of prolonging pregnancy. Multiple investigations have shown that, in patients with preterm premature rupture of the membranes, prophylactic antibiotics are of value in prolonging the latent period between rupture of the membranes and onset of labor and in reducing the incidence of maternal and neonatal infection. The most extensively tested effective antibiotic regimen for prophylaxis involves erythromycin alone or in combination with ampicilln. Controversy still exists regarding the appropriate length and route of antibiotic prophylaxis.

Anti-Bacterial Agents↗
PubMed1997

A critical review of the relationship between gestational weight gain and preterm delivery.

OBJECTIVE: To review the relationship between gestational weight gain and preterm delivery. DATA SOURCES: We identified published studies through Medline searches (for the period 1980-1996), and we reviewed bibliographies from published articles. METHODS OF STUDY SELECTION: We excluded non-English-language articles and articles that used total weight gain, unadjusted for gestational age. Thirteen articles were identified for review. TABULATION, INTEGRATION AND RESULTS: Eleven of the 13 studies reported a significant association between maternal weight gain and risk of preterm delivery, and most reported that inadequate rate of maternal weight gain was associated with an increased risk (approximately 50-100%) of preterm delivery. Studies examining pattern of gain noted that a low rate of gain during the latter part of pregnancy (but not early pregnancy) was associated with an increased risk of preterm delivery (also approximately 50-100%). The studies' findings were relatively consistent, despite the use of diverse samples, study designs, and analytic strategies. CONCLUSION: The evidence suggests that a lower rate of weight gain during pregnancy is associated with an increased risk of preterm delivery, and that a slow rate of gain during the latter part of pregnancy may be particularly important. To improve our understanding of the mechanisms of these relationships, future studies should examine pattern of gain; they should stratify analyses on the different subtypes of preterm delivery and provide more detailed descriptions of methods for assessing gestational duration.

Delivery, Obstetric↗
PubMed2000

Breech presentation is a risk factor for intrapartum and neonatal death in preterm delivery.

OBJECTIVES: To determine the prevalence of malpresentation among preterm births and to evaluate the clinical significance of malpresentation as a predictor of neonatal complications in preterm delivery. STUDY DESIGN: A cross-sectional study was conducted comparing 692 nonvertex preterm deliveries of singleton births (24-36 weeks) to 4685 vertex preterm deliveries. Women with gestational age less than 24 weeks and birthweight <500 g were excluded from the study. RESULTS: The study population included 5377 women who met the inclusion criteria. The prevalence of malpresentation was 12.8% (692/5377); 73% in the breech presentation, 22% in the transverse lie, and 5% in other positions. The mean gestational age at birth was significantly lower in the nonvertex group (32.4+/- 3.5 vs. 34.2+/-2.6; P<0.0001). Higher rates of perinatal mortality (23.1% vs. 10.1%; P<0.0001) were observed in the nonvertex group when compared with vertex births, as well as other complications such as oligohydroamnion (9.2% vs. 3.2%; P<0.0001); small-for-gestational-age; (10.5% vs. 5.9%; P<0.001); congenital anomalies (11% vs. 5.9%; P<0.001); placental abruption (8.7% vs. 4. 1%; P<0.0001); placenta previa (6.8% vs. 2.5%; P<0.0001); premature rupture of membranes (25.4% vs. 16.6%; P<0.0001); chorioamnionitis (7.9% vs. 2.9%; P<0.001); prolapse of cord (2.3% vs. 0.6%; P<0.0001) and cesarean section rate (63.9% vs. 19.1%; P<0.0001). Neonatal mortality was found to be higher for breech presentation, odds ratio (OR)=4 (confidence interval [CI]=2.76-4; P<0.0001), transverse lie, OR=2.1 (1.1-4.12; P<0.02) and for other malpositions, OR=7.3 (2. 72-20; P<0.0001). After multivariate adjustment for birthweight, cesarean section, placental pathology and chorioamnionitis, a strong association remained between the presence of breech presentation and neonatal mortality, with an adjusted OR of 2.2 (CI=1.36-3.63; P<0.01). The adjusted OR for the two other groups of malpresentation was not statistically significant. CONCLUSION: Breech presentation in preterm delivery is an independent risk factor for neonatal mortality after simultaneous adjustment for birthweight, chorioamnionitis and placental pathology. Cesarean section was found to have a protective effect on neonatal mortality rates.

Adult↗
PubMed2003

[Study of the cervix of normal pregnancy and threatened preterm delivery using transvaginal sonography].

OBJECTIVE: To observe the changes of cervix in women between 16 and 35 weeks of gestation using transvaginal ultrasound and to determine the value of the cervix length in predicting preterm delivery among the women with threatened preterm labor. METHODS: Transvaginal sonography were performed in 154 normal single nulliparous pregnant women between 16 and 35 weeks of gestation and 58 women with threatened preterm labor but without premature rupture of membrane. RESULTS: (1) There is no definitely change in either cervical length or internal diameter of cervix among the pregnant women over the studied period. There was also no funneling to be observed. The mean cervical length is (36 +/- 5) mm, and the mean cervical internal diameter is (4 +/- 1) mm. (2) Eleven preterm deliveries occurred among the 58 pregnancy women with threatened preterm labor. The cervical length by sonography of 11 preterm deliveries was (18 +/- 6) mm, and was significant shorter than the women without preterm deliveries whose mean cervical length was (32 +/- 6) mm (P < 0.001). The cervical length of women who delivered pretermly was totally <or= 26 mm. (3) A cervical length of 26 mm (x-2 s) as the cutoff to predict the preterm delivery among women with the threatened preterm labor has a 100% of sensitivity, 81% of specificity, 55% positive predictive value and a 100% of negative predictive value. CONCLUSIONS: Cervical length by transvaginal sonography can be used to predict preterm delivery among the women with threatened preterm labor. Among women treated for preterm delivery, a cervical length of less than 26 mm indicated a high risk of preterm delivery, and intensive management is required.

Adult↗
PubMed1989

Relaxin in paired samples of serum and milk from women after term and preterm delivery.

In a study to determine if relaxin could be measured in milk and if so to correlate concentrations in milk and serum, paired samples of milk and serum were collected from 12 women 3 days after term delivery (term group), from 16 women 3 days after preterm delivery (preterm group), and from some of these patients 6 weeks after delivery (eight term and six preterm). Relaxin was measured by specific human relaxin radioimmunoassay. Relaxin from milk and sera behaved similarly in the relaxin radioimmunoassay and reverse-phase high-performance liquid chromatography. Concentrations of relaxin in sera and milk collected 3 days after delivery did not differ significantly within the term or preterm groups. Neither were there differences in relaxin levels in sera and milk between the term and preterm groups. At 6 weeks postpartum, relaxin was not measured in any sera but was measured in milk from six of eight patients in the term group and five of six patients in the preterm group. Relaxin concentrations in milk were higher in the preterm group. The presence of relaxin in milk at 6 weeks postpartum suggests a nonluteal site of synthesis.

Chromatography, High Pressure Liquid↗
PubMed2006

Race, cardiovascular reactivity, and preterm delivery among active-duty military women.

BACKGROUND: Rates of preterm delivery in the United States are higher in black women compared with whites. In this study, we examined cardiovascular reactivity and risk of preterm delivery among black and white military women. METHODS: We recruited a total of 500 black and white active-duty military women from the prenatal clinic at a large military installation, interviewing them early in pregnancy and again at 28 weeks of gestation. A subgroup of women underwent a computerized stress test to determine cardiovascular reactivity assessed as increases in heart rate and blood pressure compared with measurements taken before the stress test. RESULTS: Despite a relatively low overall risk of preterm delivery (8.2%), we found the same 2-fold racial disparity reported in other populations (hazard ratio for preterm delivery in black women vs whites = 2.30; 95% confidence interval = 1.24-4.27). The disparity is present in all military ranks and is largest for medically indicated preterm deliveries. Among the 313 subjects who participated in the computerized stress testing, blacks exhibited more cardiac reactivity than whites. In black subjects only, a 1-mm increase in diastolic blood pressure reactivity was associated with 1.1 a day earlier delivery (-0.17 weeks). A similar trend was seen with heart rate. CONCLUSIONS: Autonomic dysfunction after exposure to stressors may play a role in the timing of delivery among black women.

Adult↗
PubMed2000

Differences in preterm delivery rates and outcomes in Jews and Bedouins in Southern Israel.

OBJECTIVE: (1) To compare the preterm delivery rates in the Bedouin versus the Jewish population. (2) To compare risk factors for preterm delivery in the two populations. (3) To compare outcomes of preterm delivery between the two groups. STUDY DESIGN: 41669 Jewish singletons births of whom 2816 delivered preterm (23-36 weeks) and 26495 Bedouin singletons in whom 2064 preterm deliveries occurred, were compared. All births took place in Soroka University Medical Center. Data were obtained from the computerized database of birth discharge records. RESULTS: The incidence of preterm delivery in Bedouin women was significantly higher than the rate in Jewish women (7.8 vs. 6.8%, P<0.01). The grand multiparity rate was higher among Bedouin women (P<0.001), as was the rate of teenage (<19 years) mothers (P<0.001). Gestational diabetes, PIH, and PROM rates were higher in the Jewish population (P<0.001, P=0.017, P<0.001, respectively). A bad obstetric history and previous perinatal mortality is more common in the Bedouin population (P<0.001 for both). In a logistic regression model including all these factors, the ethnic difference in the incidence of preterm delivery remained significant. The neonatal mortality rate was higher in the Bedouin population (P<0.001), as was the rate of congenital malformations (P<0.001). The perinatal mortality of Bedouins was nearly twice that of Jewish neonates with congenital malformations. However, no difference was found when neonates without congenital malformations were compared. Congenital malformations were found to be the strongest predictor of mortality. Ethnicity per se was no longer a predictor of mortality once congenital malformations were included in a logistic regression model, but the interaction of Bedouin ethnicity and congenital malformation was a significant predictor of mortality. CONCLUSION: The incidence of preterm delivery was significantly higher in Bedouin women than in Jewish women. A full explanation for this difference was not found. However, there were significantly higher rates of congenital malformations in the Bedouin preterm delivered infants. There was a much higher rate of neonatal mortality in the Bedouin population and this ethnic difference was fully explained by the presence of congenital anomalies.

Adult↗
PubMed2006

Comparison of cervical volume and cervical length to predict preterm delivery by transvaginal ultrasound.

The objective of this study was to evaluate predictive value of cervical volume and length measurement for preterm delivery in low-risk pregnancies by transvaginal ultrasound. Two hundred fifty pregnant women were underwent ultrasound examination at 22 weeks of gestation by transvaginal route. Cervical length, width, and anteroposterior diameters were measured and cervical volume was calculated. All subjects were observed until term. Predictive values of cervical length and cervical volume were calculated and compared with predict preterm delivery. Preterm delivery occurred in 18 patients (7.2%). Mean cervical length and volume were statistically different between term and preterm delivered patients ( P = 0.001). Areas under curves were 0.913 for cervical volume and 0.923 for cervical length; this difference was not statistically significant ( P = 0.289). Sensitivity of cervical volume was 73.3% for 32-mL cut-off value with 12.85% false-positive rate and cervical length had 80% sensitivity at the 33.15-mm cut-off value with 12.7% false-positive rate. Cervical volume measurement by two-dimensional ultrasound did not add any benefit compared with the cervical length measurement for prediction of preterm delivery.

Adult↗
PubMed1991

The mammary stimulation test--a predictor of preterm delivery?

Clinical risk identification for preterm delivery, the major cause of perinatal morbidity and mortality, remains problematic. To test the hypothesis that a provocative test for uterine contractility at the beginning of the third trimester would reliably identify patients destined to be delivered before and at term, we designed the mammary stimulation test. Uterine contractions in response to nipple stimulation at a mean of 28.6 weeks' gestation, were evaluated in 94 gravid patients at risk for preterm delivery. The mammary stimulation test, the results of which were not used for clinical management, was positive in 50% of patients tested and had a sensitivity of 84% and a positive predictive value of 34% (chi 2 = 11.15, p less than 0.01). Ninety-four percent of patients predicted to be delivered at term actually were delivered at term (negative predictive value). Furthermore, no patients with a negative mammary stimulation test were delivered within 1 month of testing or were delivered of infants weighing less than 2000 gm. Discriminant analysis indicated that the mammary stimulation test provided information beyond that available from clinical risk factors alone. A cost analysis suggested that the use of the mammary stimulation test could reduce the cost of ambulatory uterine activity monitoring by nearly 50%. If these findings can be validated in additional samples, the mammary stimulation test may be useful in prematurity prevention programs.

Discriminant Analysis↗
PubMed2006

17alpha-hydroxyprogesterone caproate for the prevention of preterm delivery: A cost-effectiveness analysis.

OBJECTIVE: To evaluate whether the use of 17alpha-hydroxyprogesterone caproate for the prevention of recurrent preterm deliveries is cost-effective. METHODS: Using decision-analysis modeling, we compared the cost-effectiveness of using 17alpha-hydroxyprogesterone caproate in four subgroups: 1) Prior preterm deliveries less than 32 weeks; 2) prior preterm deliveries 32-37 weeks; 3) prior term delivery; and 4) no prior delivery. Each subgroup was compared with a "no treatment" group. Costs included those for 17alpha-hydroxyprogesterone caproate, hospital admissions, and complications from preterm deliveries. The main outcome measures include cost per quality-adjusted life-year gained and the number of preterm deliveries prevented. Secondary outcomes include neonatal complications prevented. One-way and multiway sensitivity analyses were performed. RESULTS: The use of 17alpha-hydroxyprogesterone caproate for the prevention of preterm deliveries result in cost-savings in women with prior preterm deliveries less than 32 weeks and 32-37 weeks. The sensitivity analyses revealed the model to be robust over a wide range of values for evaluated variables. CONCLUSION: Within our baseline assumptions, 17alpha-hydroxyprogesterone caproate was associated with cost-savings when used for the prevention of preterm deliveries in women with prior preterm deliveries.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed2001

Evaluation of the tocolytic effect of a selective cyclooxygenase-2 inhibitor in a mouse model of lipopolysaccharide-induced preterm delivery.

The inflammatory process is known to cause preterm delivery. Recently, a cyclooxygenase (COX)-2 inhibitor has been developed as an anti-inflammatory drug with few side-effects. We evaluated the COX-2 inhibitor, Celecoxib, for its tocolytic effects and side-effects on dams and pups using a lipopolysaccharide (LPS)-induced preterm delivery mouse model (preterm delivery rates; 95%). With administration of Celecoxib (50, 10, 1 and 0.3 mg/kg), the preterm labour rate was significantly reduced to 18, 30, 36 and 60% respectively. The prostaglandin F(2alpha)(PGF(2alpha)) and PGE(2) concentrations in murine uterine tissue 4 and 10 h after LPS treatment with Celecoxib (10 and 1 mg/kg) were significantly lower than those in the LPS-treated group without CELECOXIB: With administration of 10 or 100 mg/kg Celecoxib, the fetal ductus arteriosus was constricted significantly in preterm and near-term rats, although constriction rates in preterm rats were significantly lower than those in near-term rats. Reproductive and renal functions in offspring whose mothers were treated with LPS and Celecoxib were normal. These data demonstrate that Celecoxib could be used as a new therapy for preterm labour. However, careful attention to constriction of the fetal ductus arteriosus should be given.

Animals↗