Women who give birth preterm have an increased risk of dying prematurely, according to a new US study published today (20 August 2020).
The findings suggest that women who deliver prematurely “need long term clinical follow-up for detection and treatment of chronic disorders associated with early mortality”, say the authors.
Although nearly 11% of all deliveries worldwide occur preterm and women who deliver preterm or extremely preterm have been reported to have increased risks of developing conditions such as heart disease or diabetes in later life, little is known about their long-term risk of death.
Professor Casey Crump, of the Icahn School of Medicine at Mount Sinai in New York, USA, and colleagues analysed data on the length of pregnancy for more than two million women who gave birth in Sweden from 1973 to 2015.
They went on to identify deaths from the Swedish Death Register up to 31 December 2016, giving a maximum follow up of 44 years.
Overall, 76,535 (3.5%) of women died, at an average age of 58, and after accounting for other risk factors, the research team found that women who delivered preterm or extremely preterm had 1.7-fold and 2.2-fold increased risk of death from any cause, respectively, in the following 10 years compared with those who delivered full term.
This, they say, equates to about 28 excess deaths per 100,000 person years.
The risks were highest in the first 10 years after delivery before declining. There was a 1.5-fold increased risk (equivalent to 48 excess deaths per 100,000 person years) 10-19 years after delivery, and a 1.4-fold increased risk (equivalent to 143 excess deaths per 100,000 person years) 20-44 years after delivery.
Overall, the researchers estimated 2,654 excess deaths in this cohort of women, associated with preterm delivery, equating to one excess death for every 73 women who delivered preterm.
Although the study is observational, the researchers say the large sample size and long follow-up time mean that premature delivery should be recognised as a risk factor for early mortality in women.
Crump C, Sundquist J, Sundquist K. Preterm delivery and long term mortality in women: national cohort and co-sibling study. The BMJ. August 2020. doi: 10.1136/bmj.m2533
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