Covarrubias Lorenzo Osorno, Aguirre Gladys Esther Rupay, Chapuz José Rodriguez, May Ana Isabel Lavadores, Velázquez Jorge Dávila, Eguiluz Manuel Echeverria
Departamento Clínico de Neonatología del Hospital de Gineco-Pediatría, Centro Médico Nacional Ignacio García Téllez, Instituto Mexicano del Seguro Social, Méridia, Yucatán, México.
Ginecol Obstet Mex. 2008 Sep;76(9):526-36.
Prematurity is the main cause of morbidity-mortality in developed countries newborns, and it is responsible of most none malformed newborn deaths, and half congenital neurological disability.
To determine the association between socio-economic, demographic, and obstetric maternal history, evolution of pregnancy, and premature delivery.
A cohort of live newborns was studied at Centro Médico Nacional Ignacio García Téllez since January 1st 2000 to December 31st 2004, with birth weight of 500 g or higher. Premature newborns were considered cases and those with 37 weeks of gestational age or more were controls. Prematurity prevalence was compared with and without risk factors. For each studied history it was calculated odds ratio (OR) with 95% confidence interval (95% CI), and attributed fraction in exposed and in population.
Prematurity rate observed was 11.9% (3,018/25,355). Most remarkable risk factors associated with prematurity are: illiterate mother (OR 1.54; 95% CI; 1.2-1.94), single mother, 36 years old or more (OR 1.81; 95% CI; 1.56-2.09), history of preterm delivery (OR 2.21; 95% CI; 1.54-3.16), multifetal pregnancy, obstetric morbidity (preeclampsia/eclampsia; OR 7.9; 95% CI; 6.6-9.4), gestational diabetes (OR 2.3; 95% CI; 1.75-2.92), urinary tract (OR 1.8; 95% CI; 1.56-1.96) and vaginal infection, premature rupture of membranes, oligohydramnios, polihydramnios (OR 4.48; 95% CI; 3.04-6.6), placenta previa, and abruptio placentae (OR 9.96; 95% CI; 5.62-17.7). There was not a gestational risk factor in 43% (1302/3018) of preterm deliveries.
Premature rupture of membranes and maternal morbidity during pregnancy were the most important risk factors of prematurity.
早产是发达国家新生儿发病和死亡的主要原因，它导致了大多数非畸形新生儿死亡以及一半的先天性神经残疾。
确定社会经济、人口统计学、孕产妇产科病史、孕期进展与早产之间的关联。
自2000年1月1日至2004年12月31日，在国家伊格纳西奥·加西亚·特列斯医学中心对一组出生体重500克及以上的活产新生儿进行研究。将早产新生儿视为病例，孕周37周及以上的新生儿作为对照。比较有无危险因素时的早产患病率。对于每项研究的病史，计算比值比（OR）及95%置信区间（95%CI），并计算暴露人群和总体人群中的归因分数。
观察到的早产率为11.9%（3018/25355）。与早产相关的最显著危险因素有：文盲母亲（OR 1.54；95%CI；1.2 - 1.94）、单身母亲、36岁及以上（OR 1.81；95%CI；1.56 - 2.09）、早产史（OR 2.21；95%CI；1.54 - 3.16）、多胎妊娠、产科疾病（先兆子痫/子痫；OR 7.9；95%CI；6.6 - 9.4）、妊娠期糖尿病（OR 2.3；95%CI；1.75 - 2.92）、泌尿系统（OR 1.8；95%CI；1.56 - 1.96）及阴道感染、胎膜早破、羊水过少、羊水过多（OR 4.48；95%CI；3.04 - 6.6）、前置胎盘和胎盘早剥（OR 9.96；95%CI；5.62 - 17.7）。43%（1302/3018）的早产病例不存在孕期危险因素。
胎膜早破和孕期孕产妇疾病是早产的最重要危险因素。
