连续怀孕中早产的复发风险基于其亚型
Iris T Smith1, Michael J Fassett2,3, David A Sacks4
1Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.
American journal of perinatology
|March 7, 2025
概括
以前的早产 (PTB) 显著增加了复发风险,特别是在相同的亚型. 非西班牙裔黑人和亚洲/太平洋岛屿妇女面临更高的风险,突出了差异和需要有针对性的干预措施.
科学领域:
- 产科和妇科 产科和妇科
- 围产期健康 围产期健康
- 公共卫生 公共卫生
背景情况:
- 过早分娩 (PTB) 是一个主要的公共卫生问题,具有显著的产科和围产后果.
- 患有PTB病史是已知的复发风险因素,但种族/种族,妊娠年龄,PTB亚型和妊娠间隔 (IPI) 的影响需要进一步调查.
研究的目的:
- 评估包括种族/种族,妊娠年龄,PTB亚型 (自发/指示) 和IPI在内的因素如何改变PTB复发的风险.
- 为了确定与PTB复发相关的特定风险因素和差异,在一个大,多样化的人口中.
主要方法:
- 对单子妊娠 (2009-2022) 的回顾性队列研究,使用来自南加州凯泽永久医院的电子健康记录数据.
- 包括两个 (82,610) 和三个 (14,925) 怀孕的妇女.
- 自然语言处理用于PTB亚型识别 (sPTB, iPTB);逻辑回归用于风险评估 (aOR,95%CI).
主要成果:
- 第一次PTB增加了第二次PTB的风险六倍 (23.29%对4.98%).
- 同一个PTB亚型 (sPTB:aOR 5.32; iPTB:aOR 8.26) 的复发风险更高.
- 与非西班牙裔白人相比,非西班牙裔黑人和亚洲/太平洋岛屿妇女的复发风险更高;在前两次怀孕中,PTB的风险大幅增加 (aOR 14.59).
结论:
- PTB复发风险显著增加,特别是在同一亚型和种族/族群之间,这表明持续存在的差异.
- 早期妊娠年龄 (20-33周) 的分娩显示出明显更高的复发.
- 调查结果强调需要进行亚型特定分析和有针对性的干预措施,以解决PTB复发差异.
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