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Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice
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Preterm Birth in China Between 2015 and 2016.

Chang Chen1, Jin Wen Zhang1, Hong Wei Xia1

  • 1Chang Chen, Jin Wen Zhang, Dan Chen, Chun Ming Guo, and Jun Zhang are with the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Hui Xin Zhang is with the Department of Obstetrics, Fourth Hospital of Hebei Medical University, Hebei, China. Ana Pilar Betran is with the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, and Department of Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland. Lin Zhang and Xiao Lin Hua are with the Department of Obstetrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Li Ping Feng is with the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC. Kang Sun is with the Center for Reproductive Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine. Hong Bo Qi is with the Department of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Tao Duan is with the Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai.

American Journal of Public Health
|September 20, 2019
PubMed
Summary

Preterm birth (PTB) incidence in China was 7.3% between 2015-2016. Maternal, fetal, and placental conditions contributed to PTB, with a high rate of iatrogenic births needing careful management.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Public Health

Background:

  • Preterm birth (PTB) is a significant global health concern with substantial short- and long-term consequences for infants.
  • Understanding the specific epidemiology of PTB in diverse populations, such as China, is crucial for targeted interventions.

Purpose of the Study:

  • To determine the incidence and identify risk factors and potential causes of preterm birth (PTB) in China.
  • To analyze the associations between PTB and maternal, fetal, and placental conditions.

Main Methods:

  • A population-based, multicenter study, the China Labor and Delivery Survey, was conducted from 2015 to 2016.
  • Weighted nationwide incidence of PTB was calculated.
  • Multivariable logistic regression and 2-step cluster analysis were employed to examine PTB-associated factors.

Main Results:

  • The nationwide incidence of PTB was 7.3% of all births and 6.7% of live births (≥24 weeks gestation).
  • Over 70% of PTBs occurred after 34 weeks gestation, with 42.7% being iatrogenic (medically induced).
  • Maternal, fetal, or placental conditions accounted for nearly two-thirds of PTBs, while one-third had unknown causes.

Conclusions:

  • This study provides critical data on PTB incidence and associated factors in China.
  • The high proportion of iatrogenic PTB highlights the need for careful pregnancy assessment and management.
  • Addressing the identified factors and iatrogenic causes is essential to mitigate the health consequences of PTB.