DeFranco Emily A, Stamilio David M, Boslaugh Sarah E, Gross Gilad A, Muglia Louis J
Department of Obstetrics and Gynecology and the Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, MO 63110, USA.
Am J Obstet Gynecol. 2007 Sep;197(3):264.e1-6. doi: 10.1016/j.ajog.2007.06.042.
We tested the hypothesis that short interpregnancy intervals (IPIs) increase the risk for preterm birth (PTB), recurrence of PTB, and delivery at early extremes of gestational age.
Using the Missouri Department of Health's birth certificate database, we performed a population-based cohort study of 156,330 women who had 2 births from 1989-1997. The association between IPI and subsequent pregnancy outcome was assessed.
The shortest IPIs (<6 months) increased the risk of extreme PTB (adjusted odds ratio, 1.41; 95% CI, 1.13-1.76). IPIs of <6 months and 6-12 months increased the overall risk of PTB (adjusted odds ratios, 1.48 [95% CI, 1.37-1.61] and 1.14 [95% CI, 1.06-1.23], respectively) and PTB recurrence (adjusted odds ratios, 1.44 [95% CI, 1.19-1.75] and 1.24 [95% CI, 1.02-1.50], respectively).
The risk of PTB and its recurrence increases with short IPIs, even after adjustment for coexisting risk factors. This highlights the importance of counseling women with either an initial term or preterm birth to wait at least 12 months between delivery and subsequent conception.
我们检验了以下假设,即妊娠间隔时间短会增加早产、早产复发以及在孕周极早期分娩的风险。
利用密苏里州卫生部的出生证明数据库,我们对1989年至1997年间生育两胎的156,330名女性进行了一项基于人群的队列研究。评估了妊娠间隔时间与后续妊娠结局之间的关联。
最短的妊娠间隔时间(<6个月)会增加极早早产的风险(调整后的优势比为1.41;95%置信区间为1.13 - 1.76)。<6个月和6 - 12个月的妊娠间隔时间会增加早产的总体风险(调整后的优势比分别为1.48 [95%置信区间为1.37 - 1.61]和1.14 [95%置信区间为1.06 - 1.23])以及早产复发的风险(调整后的优势比分别为1.44 [95%置信区间为1.19 - 1.75]和1.24 [95%置信区间为1.02 - 1.50])。
即使在对共存的风险因素进行调整之后,早产及其复发的风险也会随着妊娠间隔时间短而增加。这凸显了向初产足月或早产的女性提供咨询,建议她们在分娩与随后受孕之间至少等待12个月的重要性。