[Algorithm for an etiological classification of prematurity]

Authors:	J Alvarez Serra, A Balaguer, M Iriondo, A Martín Ancel, M D Gómez Roig, I Iglesias, X Krauel
Language:	Spa.
Date:	2009-10-05
Journal:	Anales de pediatria (Barcelona, Spain : 2003) (1695-4033)
Release:	An Pediatr (Barc). 2009 Oct;71(4):284-90
Abstract:	The etiology of preterm birth is difficult to classify. It is usually divided into three clinical types according to its clinical presentation: medically indicated; caused by ruptured membranes; and spontaneous or idiopathic. However, this classification is controversial, imprecise and can result in multiple interpretations when applied. OBJECTIVE: To design an etiologically based classification of preterm birth, and to design a system to easily assign each case during the perinatal period. METHODS: Review of literature, qualitative analysis using consensus methods through nominal group technique, and quantitative analysis of a pilot study using a first version of the algorithm. RESULTS: A classification is made to establish a general division between the "primary cause" and "associated causes" of preterm birth, that allows remote causes or risk factors to be included. The primary cause includes seven categories: inflammatory (ruptured membranes and related); vascular (intrauterine growth restriction and related); maternal-local; maternal-systemic; fetal pathology; fetal distress; idiopathic. The medically indicated preterm birth is defined as a previous or independent category and so is compatible with the other, previously mentioned causes . An algorithm was designed to make it easier to classify the primary cause of preterm birth using a flowchart. CONCLUSIONS: A pragmatic classification of preterm birth is proposed that may help to achieve better precision and agreement between clinicians.
Copyright:	Anales de pediatria (Barcelona, Spain : 2003) Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
Full text:	DOI - Anales de pediatria (Barcelona, Spain : 2003) (DOI) Ediciones Doyma, S.L. - HTML (Free) Elsevier Science - HTML (needs subscription)
Terms:	Algorithms, Humans, Infant, Newborn, Premature Birth