279例不明原因自发性早产的发生与季节的关系

A seasonal pattern and idiopathic spontaneous preterm birth:279 cases

目的探讨不明原因自发性早产的发生与季节的关系,并分析其母儿近期结局。方法收集2003年1月至2012年12月在广州医科大学附属第三医院治疗的不明原因自发性早产的孕产妇279例及同期广州气温进行回顾性分析。结果 279例不明原因自发早产中春季发病57例,夏季发病89例,秋季发病69例,冬季发病64例。在平均气温最高时(7月),不明原因自发性早产的发病率也达到高峰(1.07%)。夏季不明原因自发性早产发病率(1.05%)高于春季(0.75%)和秋季(0.70%),差异有统计学意义(P<0.05)。各季节气候的早期早产组、中型早产组、轻型早产组的发病率之间差异无统计学意义(P>0.05)。秋季出生的新生儿转科率高于春季、夏季和冬季(P<0.05)。而各季节发病的孕产妇的情况及新生儿出生的性别,体重及1、5 min的Apgar评分差异无统计学意义(P>0.05)。结论不明原因自发性早产的发病具有季节性,以夏季发病率最高。建立该病发病的季节模式,有助于预防早产的发生,降低新生儿死亡率,减轻家庭与国家的经济及医疗负担。

Objective To investigate the seasonal patterns of idiopathic spontaneous preterm birth and analyze the short-term outcomes of mother and newborn. Methods The clinical data of 279 cases of idiopathic spontaneous preterm birth from January2003 to December 2012 and the temperature in Guangzhou were retrospectively analyzed. Results 57 cases of idiopathic spontaneous preterm birth occurred in spring, 89 cases in summer, 69 cases in autumn and 64 cases in winter. Along with the highest average temperature in July, the morbidity of idiopathic spontaneous preterm birth reached the peak（1.07%）. In summer, the morbidity of idiopathic spontaneous preterm birth was significantly higher than in spring and autumn. There was no statistically significant among the morbidity in early preterm birth, moderate preterm birth and mild preterm birth. Rates of newborn transferred to neonatology department were significantly higher in autumn than other seasons. But in other aspects like gender, weight and Apgar score in one minute and five minutes, there were no statistically significant between seasons.Conclusion This study showed there was seasonal feature of idiopathic spontaneous preterm birth which peaked only once a year, in summer. Establishing a seasonal pattern of birth can have important implications for the delivery of healthcare services,reduce neonatal mortality, reduce the financial burden on families, and reduce medical expanse of the government.