早产影响因素的前瞻性队列研究

  目的  分析中国早产的流行现状及危险因素，为早产的预防提供参考依据。  方法  本研究数据来源于中国孕产妇队列研究·协和项目(Chinese Pregnant Women Cohort Study, CPWCS)，通过问卷调查和医院信息系统(hospital information system, HIS)收集孕妇基本情况和分娩结局。采用SPSS 26.0软件进行χ2检验和多因素Logistic回归分析模型分析。  结果  5 671名孕妇中发生早产的例数为295例，占5.2%，不同地区早产率差异无统计学意义(χ2 =0.591, P=0.771)。多因素分析结果显示:高龄、糖尿病史、早产史、胎盘早剥、胎膜早破、胎儿宫内窘迫、妊娠期高血压以及双胎是早产的危险因素(均有P < 0.05)，而在自然分娩的孕妇中，高龄(OR=2.90, 95% CI: 1.67~5.06, P < 0.001)、胎膜早破(OR=6.17, 95% CI: 4.21~9.06, P < 0.001)、双胎(OR=17.72, 95% CI: 3.23~97.25, P=0.001)是早产的主要危险因素。  结论  早产的影响因素较多，准确识别危险因素，为孕妇提供科学合理的健康教育和个性化的防治措施是预防早产的重要手段。

Influencing factors of preterm birth: a prospective cohort study

Objective To analyze the prevalence and risk factors of preterm birth in China and to provide reference for the prevention of preterm birth. Methods Data was from the Chinese Pregnant Women Cohort study(CPWCS). The basic information and delivery outcomes of pregnant women were collected through questionnaire surveys and hospital information system. The chi-square test and multivariate logistic regression analysis were conducted by SPSS 26.0 software. Results The prevalence of preterm birth among 5 671 pregnant women was 5.2%, and there was no significant difference in the prevalence of preterm birth among different regions(χ²=0.591, P=0.771). The results of multivariate logistic regression analysis showed that advanced age, history of diabetes, history of premature birth, placental abruption, premature rupture of membranes, fetal distress, hypertension during pregnancy, and twins were risk factors for preterm birth(all P<0.05), while among pregnant women who give birth naturally, advanced age(OR=2.90, 95% CI: 1.67-5.06, P<0.001), premature rupture of membranes(OR=6.17, 95% CI: 4.21-9.06, P<0.001), and twins(OR=17.72, 95% CI: 3.23-97.25, P<0.001) were risk factors for preterm birth. Conclusions There are many influencing factors of preterm birth. Accurately identifying risk factors and providing pregnant women with scientific and reasonable health education and individualized prevention and control measures are important means to prevent preterm birth.