母亲既往生育史对早产儿发生的影响

Effect of maternal prior reproductive history on preterm birth

目的探讨母亲既往生育史与早产发生的相关性。方法选取2010年1月-2012年12月在甘肃省妇幼保健院产科住院分娩的单胎活产早产儿1 019名,与同期分娩的9 160名单胎活产足月儿进行病例对照分析,应用多因素Logistic回归模型探讨母亲既往生育史与早产及不同亚型早产的关系。结果母亲既往早产史是早产及不同亚型早产发生的危险因素;既往自然流产史是早产的危险因素,随着自然流产次数的增多,早产风险明显增高,且这一风险对于早期早产的影响较中度早产更高;既往死产史是早产的危险因素;既往自然流产史与既往死产史是无胎膜早破自发性早产的危险因素;既往宫外孕史与既往妊娠史与早产及任一亚型早产的发生无相关性;既往分娩史是医源性早产的危险因素,但与自发性早产发生无相关性。结论早产的发生与既往早产史、自然流产史、死产史、分娩史密切相关,对于合并以上危险因素的育龄期妇女再次生育前应给予额外关注,以降低早产的发生率。

Objective To explore the correlation between prior reproductive history and preterm birth. Methods A total of 1 019 single live preterm birth infants and 9 160 single live term birth infants born in Department of Obstetrics in the hospital from January 2010 to December 2012 were selected,then a case-control study was performed,multivariate logistic regression model was used to explore the relationship between maternal prior reproductive history and different subtypes of preterm birth. Results Maternal prior preterm birth history was a risk factor of preterm birth and different subtypes of preterm birth. Prior spontaneous abortion history was a risk factor of preterm birth,the risk of preterm birth increased significantly with the increase of times of spontaneous abortion,the effect on early preterm birth was bigger than that on moderate preterm birth. Prior stillbirth history was a risk factor of preterm birth. Prior spontaneous abortion history and stillbirth history were risk factors of spontaneous premature delivery without premature rupture of fetal membranes. Prior ectopic pregnancy history and pregnancy history were not correlated with preterm birth and different subtypes of preterm birth. Prior delivery history was a risk factor of iatrogenic premature delivery,but it was not correlated with spontaneous premature delivery. Conclusion Preterm birth is closely correlated with maternal prior reproductive history,history of spontaneous abortion,and birth history,more attention should be paid to the women of childbearing age with the above-mentioned risk factors when they want to have another child to reduce the incidence rate of preterm birth.