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Objective: Examine the risk of preterm birth (PTB, < 37 weeks) and early term birth (37-38 weeks) for women with reported drug abuse/dependence., Study Design: The population was drawn from singleton livebirths in California from 2007 to 2012. Drug abuse/dependence was determined from maternal diagnostic codes (opioid, cocaine, cannabis, amphetamine, other, or polysubstance). Relative risks, adjusted for maternal factors were calculated for PTB and early term birth., Result: Of the 2,890,555 women in the sample, 1.7% (n = 48,133) had a diagnostic code for drug abuse/dependence. The percentage of PTBs varied from 11.6% (cannabis) to 24.3% (cocaine), compared with 6.7% of women without reported drug abuse/dependence., Conclusion: Women with reported drug abuse/dependence during pregnancy were at increased risk of having a PTB and all but those using cannabis were at risk of having an early term birth. Women using cocaine and polysubstance were at the highest risk of birth < 32 weeks.

We examined the association between gastroschisis and preterm birth (PTB, <37 weeks) by subtype. The sample was drawn from singleton live births in California from 2007 to 2012 contained in a birth cohort file maintained by the California Office of Statewide Health Planning and Development (n = 2,891,965; 1,421 with gastroschisis). Relative risks (RRs) and 95% confidence intervals (CIs) were calculated for PTB by gestational age (<34, 34-36, and any <37 weeks) and by type (spontaneous labor with intact membranes, preterm premature rupture of the membranes [PPROM], provider initiated) and were adjusted for maternal characteristics. Over 44.5% of infants with gastroschisis were born preterm because of spontaneous etiologies; notably, 8.4% of infants with gastroschisis were born <34 weeks because of spontaneous etiologies (adjusted RRs 9.1-12.2). Overall, 53.7% of infants with gastroschisis were born preterm compared with only 6.9% of infants without gastroschisis (adjusted RR 15.2, 95% CI 13.6-19.5) and are at particularly high risk of spontaneous PTB. Nearly 9% of infants with gastroschisis delivered <34 weeks, regardless of preterm etiology, indicating that these infants are at great risk for PTB morbidities in addition to the complications from gastroschisis., (© 2018 Wiley Periodicals, Inc.)

Objective: To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia., Study Design: Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC)., Results: Twenty-five serum biomarkers along with maternal age <34 years and poverty status identified >80% of women with PTB ± preeclampsia with best performance in women with preterm preeclampsia (AUC = 0.889, 95% confidence interval (0.822-0.959) training; 0.883 (0.804-0.963) testing)., Conclusion: Together with maternal age and poverty status, mid-pregnancy immune and growth factors reliably identified most women who went on to have a PTB ± preeclampsia.