Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Am J Perinatol. 2010 Feb;27(2):163-9. doi: 10.1055/s-0029-1234036. Epub 2009 Jul 30.
We compared short-term neonatal outcomes between premature infants with spontaneous preterm birth (s-PTB) and those delivered due to preeclampsia (PEC). Data were collected from women with singleton pregnancies admitted with spontaneous preterm labor (PTL) (2002 to 2005) and PEC (2005 to 2007). Patients delivering 24 to 36(6/7) weeks were analyzed. The incidence of adverse outcomes was compared. Chi-square and Fisher exact tests compared outcomes between neonates of varying gestational ages, and Poisson regression was used to control for confounders. Data describing 368 infants are included (PTL: n = 224; PEC: n = 144). Overall, s-PTB infants had less favorable outcomes at earlier gestational ages, and at later gestational ages those born preterm secondary to PEC (pec-PTB) had less favorable outcomes. s-PTB infants 24 to 27(6/7) weeks were 21% more likely to stay in the neonatal intensive care unit (NICU) > or = 8 days than pec-PTB infants (incident rate ratios [IRR] 0.79, P = 0.002, 95% confidence interval [CI] 0.68 to 0.92). Pec-PTB infants 32 to 33(6/7) weeks were 6 times more likely to stay in the NICU > or = 31 days than s-PTB infants (IRR 5.82, P = 0.03, 95% CI 1.20 to 28.31). Short-term neonatal outcomes differ by the etiology of preterm birth. These data can help facilitate proper patient counseling and allocation of resources. Future studies should address mechanisms by which the etiology of PTB leads to specific adverse outcomes, thus allowing for more direct interventional strategies.
我们比较了自发性早产（s-PTB）和子痫前期（PEC）导致的早产儿的短期新生儿结局。数据来自于 2002 年至 2005 年自发性早产临产（PTL）和 2005 年至 2007 年子痫前期的单胎妊娠孕妇。分析了 24 至 36（6/7）周分娩的患者。比较了不良结局的发生率。使用卡方检验和 Fisher 确切概率法比较了不同胎龄新生儿的结局，并用泊松回归控制混杂因素。描述了 368 名婴儿的数据（PTL：n = 224；PEC：n = 144）。总的来说，s-PTB 婴儿在较早的胎龄时结局较差，而在较晚的胎龄时，因 PEC 导致的早产儿（pec-PTB）结局较差。24 至 27（6/7）周的 s-PTB 婴儿在新生儿重症监护病房（NICU）>或=8 天的可能性比 pec-PTB 婴儿高 21%（发生率比 [IRR]0.79，P = 0.002，95%置信区间 [CI]0.68 至 0.92）。32 至 33（6/7）周的 pec-PTB 婴儿在 NICU 停留>或=31 天的可能性比 s-PTB 婴儿高 6 倍（IRR 5.82，P = 0.03，95%CI 1.20 至 28.31）。早产儿的短期新生儿结局因早产的病因不同而不同。这些数据可以帮助更好地为患者提供咨询和分配资源。未来的研究应该探讨早产病因导致特定不良结局的机制，从而可以制定更直接的干预策略。
