湖南浏阳市早产发病率及其影响因素研究  

A population based study on incidence and determinants of preterm birth in Liuyang Hunan

作　　者：郭亚伟[1] 谭红专[1] 周书进 罗美玲[1] 王莎亚[1] 蔡畅[1] 胡丽[1] 何玥[1] 柳祎[1] 沈琳[1] 文师吾[1] 

机构地区：[1]中南大学公共卫生学院流行病与卫生统计学系,长沙410078 [2]湖南省浏阳市妇幼保健院,湖南浏阳410300

出　　处：《中南大学学报（医学版）》2013年第4期413-418,共6页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(30872167)~~

摘　　要：目的：了解浏阳市农村早产的发病情况，并探讨其相关危险因素。方法：采用整群随机抽样的方法在浏阳市37个乡镇中随机抽取14个乡镇，以所抽乡镇妇幼保健部门2010年1月至2011年12月间登记建册的所有孕产妇为研究对象，对队列人群孕早、孕中、孕晚及分娩各期进行随访，并收集病历资料和孕产妇保健手册资料。单因素分析采用f检验，多因素分析采用非条件logistic回归分析，以探讨早产发生的主要影响因素。结果：共收集到6270名孕妇的资料，其中有259例诊断为早产，早产发生率为4．13％。多因素非条件logistic回归分析结果显示：影响早产发生的主要危险因素有：胎盘早剥（OR=7．678，95％CI：2．249～26．215），胎膜早破（OR=5．177，95％CI．3．945—6．793），子宫异常及畸形（OR=2．675，95％CI：1．007～7．107），胎盘异常（OR=2．633，95％CI．1．666～4．162），妊娠期高血压（OR=2．172，95％CI：1．044～4．521），妊娠合并症（OR=1．806，95％CI：1．033～3．157），男性胎儿（OR=I．429，95％CI：1．086-1．881）。早产的保护因素包括：产检次数多（OR=0．502，95％CI：0．409～0．615）和单胎妊娠（OR=0．155，95％CI：0．075～0．319）。结论：早产是多因素综合作用的结果，应针对胎盘早剥、胎膜早破、男胎等危险因素尽早采取综合性控制措施以减少早产的发生。Objective： To describe the incidence and to discuss the risk factors of premature birth in rural areas of Liuyang. Methods： We collected subjects from villages and towns in Liuyang through cluster sampling method. Before enrolling in this cohort, all of them had established health records from January 2010 to December 2011. We followed up the early, middle and late stages of pregnancy until delivery and collected medical records and maternal health care manual of this cohort as our data materials. We explored the main influence factors of premature delivery by X2 test and unconditional logistic regression analysis for single factor and multivariate analysis. Results： Among 6270 women who enrolled in our cohort, 259 were diagnosed as premature birth. The incidence （4.13%） was lower than the national average level. Non-conditional logistic regression analysis showed that the risk factors of premature birth were as follows： OR of placental abruption was 7.678 （95% CI： 2.249-26.215）, that of premature rupture of fetal membranes （PROM） was 5.177 （95% CI： 3.945-6.793）, that of uterine abnormal and deformity was 2.675 （95% CI： 1.007-7.107）, that of placenta anomaly was 2.633 （95% CI： 1.666-4.162）, that of hypertension in pregnancy was 2.172 （95% CI： 1.044-4.521）, that of pregnancy complications was 1.806 （95% CI： 1.033-3.157）, that of male fetus was 1.429 （95% CI： 1.086-1.881）. Protective factors ofpreterm birth were too frequent prenatal examination （0R=0.502, 95% CI： 1.033-3.157） and single pregnancy （OR=0.155, 95% CI： 0.075-0.319）. Conclusion： Preterm delivery is caused by complicated factors, such as placental abruption, PROM and male fetus. Comprehensive measures should be taken to reduce preterm birth.

关 键 词：早产 发生率 影响因素 非条件LOGISTIC回归 

分 类 号：R714.2[医药卫生—妇产科学]