Ancel P Y
INSERM U149, Unité de Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif Cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2002 Nov;31(7 Suppl):5S10-21.
Preterm labor (PL) is the main cause for hospital admission during pregnancy. 50% of all pregnant women are diagnosed with PL. 7% of all neonates are born prematurely and one third of all preterm births follow PL with intact membranes. Previous history of preterm delivery, young maternal age, low socio-economical status are established risk factors of PL with intact membranes. Intrauterine infection, abruptio placenta praevia and uterine and cervical anomalies are often associated with PL with intact membranes. Cytokines, cortico-releasing hormone and the fetal hypothalamic-pituitary-adrenal axis could trigger the prostaglandin cascade leading to PL. However data are lacking to conclude. Intrauterine infection can also lead to neonatal infection in the preterm babies. This is also an important risk factor of cerebral lesions and cerebral palsy. Outside perinatal infection, PL does not seem to increase neonatal death and neonatal morbidity compared with other causes of preterm delivery.
早产是孕期住院的主要原因。所有孕妇中有50%被诊断为早产。所有新生儿中有7%为早产，所有早产中有三分之一是胎膜完整的早产。既往早产史、产妇年龄小、社会经济地位低是胎膜完整早产的既定风险因素。宫内感染、前置胎盘早剥以及子宫和宫颈异常常与胎膜完整的早产相关。细胞因子、促肾上腺皮质激素释放激素和胎儿下丘脑 - 垂体 - 肾上腺轴可触发前列腺素级联反应导致早产。然而，尚无足够数据得出结论。宫内感染还可导致早产婴儿发生新生儿感染。这也是脑损伤和脑瘫的重要危险因素。除围产期感染外，与其他早产原因相比，早产似乎不会增加新生儿死亡和新生儿发病率。
