Hsieh T'sang-T'ang, Chen Szu-Fu, Shau Wen-Yi, Hsieh Ching-Chang, Hsu Jenn-Jeih, Hung Tai-Ho
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
J Soc Gynecol Investig. 2005 Apr;12(3):202-7. doi: 10.1016/j.jsgi.2004.12.004.
To examine the impact of the interpregnancy interval and a previous preterm birth on the subsequent risk of a preterm birth.
A retrospective analysis was conducted on a group of 4072 women who had at least two consecutive births, excluding multiple gestation, fetal anomalies, cervical incompetence, and stillbirth. Multivariate logistic regression was used to investigate the association between interpregnancy interval, preterm birth of the first child in the pair (index pregnancy), and the risk of a preterm birth of the second child in the pair (outcome pregnancy).
Women with interpregnancy intervals of less than 12 months (odds ratio [OR] 1.3; 95% confidence interval [CI] 1.0-1.7) were at increased risks of preterm birth with the outcome pregnancy. Furthermore, there was an increased risk for a subsequent preterm birth in women who had a preterm birth in the index pregnancy (OR 4.2; 95% CI 3.0-6.0). The risk decreased as the interpregnancy interval increased, with a relatively low risk at 18 to 48 months; subsequently, it increased sharply. In contrast, women who had delivered their previous infants at term carried an increased risk of preterm birth with the outcome pregnancy only if the interval was less than 6 months.
A difference was found in the impact of the interpregnancy interval on the subsequent risk of preterm birth between women with a prior preterm birth and those who previously delivered an infant at term.
探讨妊娠间隔和既往早产对后续早产风险的影响。
对一组4072名至少有两次连续分娩的女性进行回顾性分析,排除多胎妊娠、胎儿畸形、宫颈机能不全和死产情况。采用多因素logistic回归分析妊娠间隔、该对中的第一个孩子(索引妊娠)早产与该对中的第二个孩子(结局妊娠)早产风险之间的关联。
妊娠间隔小于12个月的女性(比值比[OR]1.3;95%置信区间[CI]1.0 - 1.7),其结局妊娠发生早产的风险增加。此外,索引妊娠早产的女性后续发生早产的风险增加(OR 4.2;95% CI 3.0 - 6.0)。随着妊娠间隔增加,风险降低,在18至48个月时风险相对较低;随后,风险急剧增加。相比之下,既往足月分娩的女性,只有当间隔小于6个月时,其结局妊娠发生早产的风险才会增加。
发现既往有早产史的女性与既往足月分娩的女性相比,妊娠间隔对后续早产风险的影响存在差异。