早期出産の流行病学と原因
Robert L Goldenberg1, Jennifer F Culhane, Jay D Iams
1Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA 19102, USA. rgoldenb@drexelmed.edu
Lancet (London, England)
|January 8, 2008
まとめ
幼児死亡の主な原因である早産は,指示された出産と複数の妊娠のために増加しています. 短い子宮頸部長と胎児フィブロネクチンは,自発的な早産を予測する.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 新生児医学 新生児医学
- 公共衛生は公衆衛生である.
背景:
- 胎児の早産 (妊娠37週未満) は,先進国における胎児間疾患と死亡率の主な原因である.
- 早期出産は,自発的出産,早産前膜破裂 (PPROM),および指示された早産に分類されます.
- 世界的な早産率は,特に先進国では,早産と助産生殖による複数の出産が増加しているため,上昇しています.
研究 の 目的:
- 胎児の早産に関する3部連載の第1部を掲載します.
- 原因,危険因子,早産の予測要因を概説する.
- 早期出産の公衆衛生上の重要性を強調する.
主な方法:
- 文献レビューと早産に関する既存のデータの合成.
- 疫学的傾向と要因の分析.
- spontaneous preterm birth の主要な臨床予測因子の特定. spontaneous preterm birth の主要な臨床予測因子の特定.
主要な成果:
- 早期出産率は,多くの先進国では5-9%から,米国では12-13%までです.
- 指示された早産は,しばしば子宮前出血症/子宮内出血症および子宮内成長制限によるものです.
- 自発的な早産は,感染,炎症,血管疾患,子宮過剰膨張の影響を受ける多因性です.
結論:
- 短い子宮頸部長と子宮頸部-陰道胎児線維素の上昇は,自発的な早産の強い予測要因です.
- 自発的な早産の危険因子には,早産前の出産,黒人人種,歯周病,母親の低BMIが含まれます.
- 早期出産の様々な原因と予測要因を理解することは,効果的な予防と管理戦略にとって極めて重要です.
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