重新评估产前护理利用与早产现有趋势之间的关联
Macie L Champion1,2, Elisa T Bushman1,2, Kimberly D Martin1,3
1Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
American journal of perinatology
|March 27, 2024
概括
产前护理 (PNC) 与早产 (PTB) 的风险有关. 不充分或低于最佳的PNC显著增加了PTB的几率,随着时间的推移,这种关联会得到加强.
科学领域:
- 生殖健康 生殖健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 公共卫生
背景情况:
- 产前护理 (PNC) 对母亲和婴儿健康至关重要.
- 过早分娩 (PTB) 仍然是一个重大的全球健康问题.
- 现有研究表明PNC利用率与PTB率之间存在联系.
研究的目的:
- 评估近三十年来PTB的趋势.
- 评估不同程度的PNC利用率与PTB之间的关联.
- 检查PNC和PTB之间的关联如何随着时间的推移而演变.
主要方法:
- 从1991年到2018年对单个,非异常分娩的回顾性队列研究.
- 根据世卫组织的指导方针,PNC利用率被分类为充足 (≥8次访问),低于最佳 (5-7次访问) 或不足 (<5次访问).
- 后勤回归分析以确定PNC和PTB之间的关联,根据出生年份进行效果修改.
主要成果:
- 在92,294个交付中,有15%的交付结果是PTB.
- 不足够的PNC (aOR 6.21) 和低于最佳PNC (aOR 3.57) 与足够的PNC相比,与PTB的更高几率显著相关.
- 不充分的PNC和PTB之间的关联随着时间的推移而加剧,赔率比率从1998年的5.4增加到2018年的9.1.
结论:
- 尽管PNC使用率有所增加,但PTB的发病率却有所上升.
- 不充分和低于最佳的PNC是PTB的重要风险因素.
- 近年来,与PNC不足相关的PTB风险变得更加明显.
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