早产及其影响因素研究——甘肃省人民医院妇产科分娩记录分析

Studies on Premature Delivery and Its Affecting Factors——Analyses of Delivery Log from Obsterics Department of Gansu Provincial Hospital

运用甘肃省人民医院产科1995～2002年产科分娩登记资料，采用卡方检验、多元Logistic回归等统计方法对早产和可能的影响因素进行关联分析．研究结果表明：9234例活产儿中，平均早产发生率为6．4％，并有逐年上升的趋势．单因素分析表明，与早产相关的因素主要有：产妇年龄、职业、有无产前检查、孕产次、胎盘异常、胎膜早破、妊娠合并症、胎位异常、多胎妊娠等．经多元Logistic回归控制主要混杂因素后，以干部为照组，商业服务业个体户人员的OR为1．44（95％CI=1．05—1．98），无业者为1．46（959／6CI=1．07—2．00），农民为1．50（959／6CI=1．05—2．15），无产前检查者oR为4．50（95％CI=3．48—5．83）；另外，前置胎盘、妊娠期间患有合并症、胎膜早破、胎位异常、多胎妊娠者发生早产的危险性均高于对照组，且均具有统计学意义．孕次、产次、季节等与早产无统计学联系．结果证明：早产发生率有逐年上升的趋势．农民、商业服务业人员、个体户人员或无业者易发生早产．无产前检查、前置胎盘、妊娠期间患有合并症者、胎膜早破、胎位异常、多胎妊娠均为早产的主要危险因素．

Our objective was to observe the incidence and the recent-year developing trend of premature delivery, and explore the chief affecting factors as well as their affecting strength. With the data of delivery log of obsterics department of Gansu provincial hospital from 1995 through 2002 and using chi square test and muhielement Logistic regression, we made a statistical analysis of the premature delivery and its affecting factors. Among 9293 cases in which chidbirths were ultimate successful, the incidence of premature delivery was 6.4%, with a by-year ascending trend. One-factor analysis showed that the related factors to premature delivery included age ,occupation, the history of ever having prenatal check-up, the number of pregnancy and delivery, anomaly of placenta, premature rupture of membrane, pregnancy complications, abnormal fetal position, muhifetation etc. After controlling certain confounding factors, the muhielement Logistic regression showed that： with staff group as the control group, the OR of trade service men and private traders was 1.44（95%CI=1.05-1.98）, that of out-of-work laborers 1.46（95% CI=1. 07-2.00）, of peasants 1.50（95%CI=1.05--2.15）, of those without prenatal check-up 4.50（95% CI=3.48-5.83） respectively. Moreover, the risks of premature delivery of those with placenta praevia, pregnancy complications, premature rupture of membrane, abnormal fetal position, multifetalplacenta praevia, pregnancy complications, premature rupture of membrane, abnormal fetal position, muhifetation were statistically higher than control group. The factors of number of pregnancy or delivery and the year＇s seasons did not show statistical association with premature delivery. Our conclusion is a higher incidence of premature delivery arose year by year. The incidences of premature delivery are relatively higher among those women of peasants, trade service men and private trade individuals, and out-of-work laborers. The chief affecting factors related to premature delivery include those without prenatal check-up, with placenta praevia, pregnancy complications, premature rupture of membrance, abnormal fetal position, and multifetation.