流行病学和早产的原因
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
概括
过早分娩是婴儿死亡的主要原因,由于指定的分娩和多胎妊娠,其数量正在增加. 短的宫长度和胎儿纤维生素预测了自发的早产.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 公共卫生 公共卫生
背景情况:
- 在发达国家,早产 (<37周怀孕) 是围产期发病率和死亡率的主要原因.
- 过早分为自发分娩,过早的膜破裂 (PPROM) 和指示过早分娩.
- 全球早产率正在上升,特别是在发达国家,由于早产和辅助生殖多胎的增加.
研究的目的:
- 提供关于早产的三部分系列的第一部分.
- 概述早产的原因,危险因素和预测因素.
- 突出早产对公共卫生的重要性.
主要方法:
- 文献综述和对早产现有数据的综合.
- 对流行病学趋势和促成因素的分析.
- 确定自发早产的关键临床预测因素.
主要成果:
- 在许多发达国家,早产率从5-9%不等,在美国为12-13%.
- 指定的早产通常是由于子宫前/子宫和子宫内生长限制.
- 自发早产是多因素的,受感染,炎症,血管疾病和子宫过膨胀的影响.
结论:
- 宫长短和宫-阴道胎儿纤维素升高是自发早产的强有力的预测因素.
- 自发早产的危险因素包括先前的早产,黑人种族,牙周病和母亲的低BMI.
- 了解早产的各种原因和预测因素对于有效的预防和管理策略至关重要.
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