Ananth Cande V, Vintzileos Anthony M
Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-1977, USA.
Clin Perinatol. 2008 Mar;35(1):53-67, viii. doi: 10.1016/j.clp.2007.11.001.
Preterm birth complicates over 500,000 births annually, affecting 12.5% of pregnancies in the United States. Much of the temporal increase in preterm birth (<37 weeks) over the past decade is largely driven by a concurrent temporal increase in medically indicated preterm birth. Maternal and fetal indications that prompt an intervention at preterm gestational ages include preeclampsia, intrauterine growth restriction, and placental abruption-conditions that constitute "ischemic placental disease." Ischemic placental disease is implicated in over one of every two indicated preterm births compared with less than one in five births at term. Comprehensive evaluation of risk factors, with careful consideration of heterogeneity in the syndrome of medically indicated preterm birth and ischemic placental disease may provide important clues to predict and consequently prevent preterm birth.
早产每年使超过50万例分娩复杂化，影响美国12.5%的妊娠。过去十年中早产（<37周）的时间增加很大程度上是由同期医学指征早产的时间增加所驱动的。促使在早产孕周进行干预的母体和胎儿指征包括子痫前期、胎儿生长受限和胎盘早剥，这些情况构成了“缺血性胎盘疾病”。与足月分娩中每五例不到一例相比，缺血性胎盘疾病与每两例医学指征早产中的一例以上有关。对风险因素进行综合评估，仔细考虑医学指征早产和缺血性胎盘疾病综合征中的异质性，可能为预测并因此预防早产提供重要线索。
