北京市通州区单胎孕妇2013-2017年早产发生情况及危险因素研究

Prevalence and risk factors of preterm birth among singletons from 2013 to 2017 in Tongzhou district of Beijing

目的 了解北京市通州区2013-2017年单胎妊娠孕妇的早产发生情况及影响因素,为降低早产的发生提供科学依据。方法 采用回顾性队列研究的方法,通过医院电子信息系统获得2013-2017年单胎孕妇的社会人口学资料、孕产史及本次妊娠情况,分析早产发生率以及不同因素对早产发生率的影响,采用多因素Logistic回归分析早产的危险因素。结果 2013-2017年通州区单胎孕妇的早产发生率为4.1%(1 418/34 726)。其中,自发性早产和治疗性早产分别占68.8%(975/1 418)和31.2%(443/1 418)。产妇年龄≥35岁(OR=1.314,95%CI:1.113~1.551)、经产妇(OR=1.399,95%CI:1.223~1.600)、男胎(OR=1.237,95%CI:1.100~1.390)、前置胎盘(OR=10.162,95%CI:7.100~14.546)、胎盘早剥(OR=9.201,95%CI:6.596~12.837)、胎膜早破(OR=3.328,95%CI:2.953~3.750)、妊娠期糖尿病(OR=1.232,95%CI:1.082~1.403)、妊娠期高血压疾病(OR=3.283,95%CI:2.755~3.911)是早产的危险因素。其中,产妇失业或待业(OR=1.159,95%CI:1.003~1.339)、丈夫年龄≥35岁(OR=1.243,95%CI:1.036~1.490)、初次妊娠(OR=1.407,95%CI:1.157~1.710)、经产妇(OR=1.295,95%CI:1.049~1.598)、男胎(OR=1.273,95%CI:1.109~1.462)是自发性早产的危险因素。结论 对于年龄≥35岁,经产妇,男胎、前置胎盘、胎盘早剥、胎膜早破、妊娠期糖尿病及高血压疾病的孕妇,应及早采取预防措施以降低早产发生率。

Objective To know about the prevalence and risk factors of preterm birth among singletons from 2013 to 2017 in Tongzhou district of Beijing,in order to provide scientific evidence for effective interventions to reduce preterm birth rate.Methods The information of all pregnant women with singleton births from 2013 to 2017 were collected from hospital information system,including demographic data,pregnancy history and current pregnancy information.A retrospective study was conducted to analyze the incidence and influencing factors of preterm birth,and multivariate Logistic regression analysis was used for exploring the risk factors related to preterm birth.Results The prevalence rate of preterm birth in Tongzhou district of Beijing from 2013 to 2017 was 4.1%(1 418/34 726).Spontaneous preterm birth and iatrogenic preterm birth accounted for 68.8%(975/1 418)and 31.2%(443/1 418)of all preterm birth,respectively.Maternal age≥35 years old(OR=1.314,95%CI:1.113-1.551),multipara(OR=1.399,95%CI:1.223-1.600),male fetus(OR=1.237,95%CI:1.100-1.390),placenta previa(OR=10.162,95%CI:7.100-14.546),placental abruption(OR=9.201,95%CI:6.596-12.837),premature rupture of membranes(OR=3.328,95%CI:2.953-3.750),gestational diabetes mellitus(OR=1.232,95%CI:1.082-1.403),and hypertensive disorder complicating pregnancy(OR=3.283,95%CI:2.755-3.911)were risk factors of preterm birth.Being unemployed or underemployed(OR=1.159,95%CI:1.003-1.339),paternal age≥35 years old(OR=1.243,95%CI:1.036-1.490),being pregnant for the first time(OR=1.407,95%CI:1.157-1.710),multipara(OR=1.295,95%CI:1.049-1.598),and male fetus(OR=1.273,95%CI:1.109-1.462)were risk factors of spontaneous preterm birth.Conclusion For pregnant women who were over 35 years old,multipara,with male fetus,placenta previa,placental abruption,premature rupture of membranes,complicated with gestational diabetes mellitus and hypertensive disorder,it is supposed to take preventive measures in order to reduce the premature rate.