早产危险因素的前瞻性队列研究  

Risk factors for preterm birth:a prospective cohort study

作　　者：叶长翔 陈生宝 王婷婷 张森茂 秦家碧 陈立章 YE Chang-Xiang;CHEN Sheng-Bao;WANG Ting-Ting;ZHANG Sen-Mao;QIN Jia-Bi;CHEN Li-Zhang(Department of Epidemiology and Medical Statistic,Xiangya School of Public Health,Central South University,Changsha 410078,China)

机构地区：[1]中南大学湘雅公共卫生学院流行病学与卫生统计系,湖南长沙410078 [2]临床流行病学湖南省重点实验室,湖南长沙410078 [3]湖南省疾控中心传染病防控科,湖南长沙410005 [4]湖南省妇幼保健院国家卫健委出生缺陷研究与预防重点实验室,湖南长沙410008

出　　处：《中国当代儿科杂志》2021年第12期1242-1249,共8页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金项目(82073653、81803313);湖南省托举人才项目(2020TJ-N07);中国博士后基金项目(2020M682644);湖南省重点研发计划项目(2018SK2063)。

摘　　要：目的了解早产的发生情况,并探讨早产发生的危险因素。方法以2014年5月至2016年12月在湖南省妇幼保健院首次参加产前检查并决定住院分娩的孕早期孕妇及其配偶为研究对象开展前瞻性队列研究。采用调查问卷收集可能与早产发生相关的暴露信息,并通过医院病历系统完成信息核查,记录妊娠结局。采用多因素logistic回归分析探讨早产发生的危险因素。结果共收集6764例孕妇完整资料,其早产发生率为17.09%。多因素logistic回归分析显示,孕妇有不良妊娠史、孕前进食槟榔、有妊娠并发症史、有肝炎史、孕期未补充叶酸、孕期服药、孕期主动/被动吸烟、孕期饮酒、孕期不均衡饮食、孕期强体力活动、受孕方式为不孕经治疗自然受孕和辅助受孕,以及配偶年龄较大、体重指数较高、吸烟均为早产发生的危险因素(P<0.05);而孕妇教育水平高、配偶教育水平高、孕次少是早产发生的保护因素(P<0.05)。结论早产的危险因素很多,应特别注重孕妇的孕期生活行为,对孕妇及其配偶加强卫生宣教,养成良好的生活习惯,以减少早产的发生。Objective To investigate the incidence of preterm birth and risk factors for preterm birth.Methods A prospective cohort study was performed for the pregnant women in early pregnancy and their spouses,who underwent prenatal examination for the first time in Hunan Provincial Maternal and Child Health Care Hospital from May 2014 to December 2016 and decided to be hospitalized for delivery.A questionnaire survey was performed to collect exposure information possibly related to preterm birth.The hospital's medical record system was used for information verification and to record the pregnancy outcome.A multivariate logistic regression analysis was used to investigate the risk factors for preterm birth.Results A total of 6764 pregnant women with complete data were included,and the incidence rate of preterm birth was 17.09%.The multivariate logistic regression analysis showed that a history of adverse pregnancy outcomes,eating areca nut before pregnancy,a history of pregnancy complications,a history of hepatitis,no folate supplementation during pregnancy,medication during pregnancy,active smoking and passive smoking during pregnancy,drinking during pregnancy,unbalanced diet during pregnancy,high-intensity physical activity during pregnancy,and natural conception after treatment of infertility or assisted conception as the way of conception were risk factors for preterm birth(P<0.05).Additionally,the pregnant women whose spouses were older,had a higher body mass index or smoked had an increased risk for preterm birth(P<0.05).A higher level of education of pregnant women or their spouses and lower gravidity were protective factors against preterm birth(P<0.05).Conclusions There are many risk factors for preterm birth.Special attention should be paid to the life behaviors of pregnant women during pregnancy,and health education should be strengthened for pregnant women and their spouses to develop good living habits and reduce the incidence of preterm births.

关 键 词：早产 危险因素 前瞻性队列研究 孕妇 

分 类 号：R722.6[医药卫生—儿科]