Rodrigues Teresa, Barros Henrique
Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
Eur J Obstet Gynecol Reprod Biol. 2008 Feb;136(2):184-8. doi: 10.1016/j.ejogrb.2007.03.014. Epub 2007 May 9.
Short interpregnancy intervals are related to increased prevalence of adverse perinatal outcomes. However, the reported association with preterm birth might be due to confounding by factors such as previous pregnancy outcomes, socioeconomic level or lifestyles. The objective of this study was to evaluate the effect of short interpregnancy interval on the occurrence of spontaneous preterm delivery.
The prevalence of a short interpregnancy interval, defined as six or less months between a preceding delivery or abortion and the last menstrual period before index pregnancy, was compared between 263 spontaneous preterm (<37 weeks) and 299 term (37-42 weeks) consecutive births. Separate analyses were performed for early (<34 weeks) and late (34-36 weeks) preterm deliveries. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated using unconditional logistic regression.
There was a significant association between short interpregnancy interval and spontaneous early preterm delivery, both crude (OR=3.9; 95% CI: 1.91-8.10) and adjusted for maternal age, school education, previous birth outcomes, antenatal care, smoking habits, body mass index and gestational weight gain (adj(OR)=3.6; 95% CI: 1.41-8.98). No significant effect on spontaneous late preterm delivery was found (crude(OR)=0.8; 95% CI: 0.32-1.83).
This study showed that short interpregnancy intervals significantly increased the risk of early spontaneous preterm birth but no such effect was evident for late preterm deliveries.
妊娠间隔时间短与不良围产期结局的患病率增加有关。然而,所报道的与早产的关联可能是由于先前妊娠结局、社会经济水平或生活方式等因素的混杂作用。本研究的目的是评估妊娠间隔时间短对自发性早产发生的影响。
比较了263例自发性早产(<37周)和299例足月产(37 - 42周)连续分娩中,妊娠间隔时间短(定义为前次分娩或流产与本次妊娠前最后一次月经之间间隔6个月或更短时间)的患病率。对早期(<34周)和晚期(34 - 36周)早产分别进行分析。使用无条件逻辑回归计算粗比值比(OR)和调整后的比值比以及95%置信区间(CI)。
妊娠间隔时间短与自发性早期早产之间存在显著关联,粗OR为3.9;95%CI:1.91 - 8.10,在调整了产妇年龄、学校教育程度、既往分娩结局、产前护理、吸烟习惯、体重指数和孕期体重增加后,调整后的OR为3.6;95%CI:1.41 - 8.98。未发现对自发性晚期早产有显著影响(粗OR = 0.8;95%CI:0.32 - 1.83)。
本研究表明,妊娠间隔时间短显著增加了早期自发性早产的风险,但对晚期早产没有明显影响。