母亲不良孕产史对早产发生的影响  

The impact of maternal adverse reproductive history on preterm birth

作　　者：王文第[1] 陈亚[1] 张春花[1] 王剑[1] 王燕侠[1] 

机构地区：[1]甘肃省妇幼保健院,兰州730050

出　　处：《中国优生与遗传杂志》2016年第9期56-59,68,共5页Chinese Journal of Birth Health & Heredity

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2015-21)

摘　　要：目的探讨母亲不良孕产史与单胎活产早产儿发生的相关性。方法选取2011年1月-2012年12月甘肃省妇幼保健院产科分娩的753例单胎活产早产儿为病例组,另选择同期本院分娩的单胎活产足月儿6505例作为对照组,应用非条件Logistic回归分析的方法探讨母亲不良孕产史与早产及不同亚型早产的关系。结果母亲既往早产史与早产(OR 16.29,95%CI 9.51-27.90)及不同亚型早产的发生强烈相关联。既往死产史(OR 1.87,95%CI 1.17-2.99)与既往自然流产史(OR 1.41,95%CI 1.09-1.82)是早产发生的危险因素,且主要与早期早产的发生相关。既往自然流产史与医源性早产(OR 1.69,95%CI 1.15-2.49)及自发性早产(OR 1.39,95%CI 1.02-1.89)的发生相关,且其与自发性早产的相关性主要局限于无胎膜早破自发性早产(OR 2.59,95%CI 1.38-4.87)。既往人工流产史与早期早产(OR 1.70,95%CI1.11-2.59)的发生相关。既往宫外孕史与早产发生无相关性。结论既往早产史、死产史、自然流产史、人工流产史均是早产发生的危险因素,并且多数可以导致早期早产。对于合并以上危险因素的孕龄期女性,应给予额外关注,做好孕前、孕期宣教,从而降低早产的发生。Objective：To explore the association between maternal adverse reproductive history and single live preterm birth. Methods：From Jan 2011 to Dec 2012,in Gansu Provincial Maternity and Child Care Hospital,753 preterm birth cases,studied in aggregate,and in subgroups,were compared with 6505 women who delivered at term. Multivariate logistic regression models were used to estimate odds ratios（OR） and 95% CI. Results：Maternal history of prior preterm birth was associated with increased risk of preterm birth overall（OR 16.29,95% CI 9.51-27.90）,and all subtypes. Prior stillbirth（OR 1.87,95% CI 1.17-2.99） and prior spontaneous abortion（OR 1.41,95% CI 1.09-1.82） were risk factors for preterm birth,and these associations appeared to be stronger for very preterm birth. Prior spontaneous abortion was associated with increased risk of indicated preterm birth（OR 1.69,95% CI 1.15-2.49） and spontaneous preterm birth（OR 1.39,95% CI 1.02-1.89）,However,the risk of spontaneous preterm was limited to that without PPROM（OR 2.59,95% CI 1.38-4.87）. Prior induced abortion was associated with increased risk with very preterm（OR 1.70,95% CI 1.11-2.59）. Prior ectopic pregnancy was not associated with preterm birth. Conclusion：Our finding support the hypothesis that maternal history of prior preterm birth,prior stillbirth,prior spontaneous abortion,and prior induced abortion are risk factors for preterm birth,and most of these are associated with increased risk of very preterm birth. Our findings suggest that physicians who are providing prenatal care should provide extra attention and health service to women with certain adverse reproductive history factors,in order to effectively reduce the incidence of preterm birth.

关 键 词：不良孕产史 早产 非条件LOGISTIC回归 病例对照研究 

分 类 号：R714.2[医药卫生—妇产科学]