Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):342-6. doi: 10.1016/j.ejogrb.2011.09.024. Epub 2011 Oct 27.
The aim of this study was to identify maternal risk factors for spontaneous preterm birth (PTB) compared to delivery at term, in order to recognize high risk women and to provide a global overview of the Italian situation.
A multicenter, observational and retrospective, cross-sectional study was designed. The study population comprised 7634 women recruited in 9 different University Maternity Hospitals in Italy. The main criteria for inclusion were: women having had vaginal preterm or term spontaneous delivery in each participating centre during the study period. The records related to deliveries occurring between April and December 2008. A multivariable logistic regression was employed to identify independent predictors of spontaneous preterm birth. Odds ratios (ORs) and 95% confidence intervals (95% CI) were reported with two-tailed probability (p) values. Statistical calculations were carried out using SAS version 9.1. A two-tailed p-value of 0.05 was used to define statistical significant results.
A significant increased risk of PTB was found in women with BMI>25 (OR=1.662; 95% CI=1.033-2.676; p-value=0.0365) and in women employed in heavy work (OR=1.947; 95% CI=1.182-3.207; p-value=0.0089). Moreover there was a significant association between PTB and previous reproductive history. In fact a history of previous abortion (OR=1.954; 95% CI=1.162-3.285; p-value=0.0116) or previous cesarean section (OR=2.904; 95% CI=1.066-7.910; p-value=0.0371) was positively correlated to the increased risk of PTB and an important statistically significant association was calculated between PTB and previous pre-term delivery (OR=3.412; 95% CI=1.342-8.676; p-value=0.0099). All the other covariates examined as potential risk factors for PTB were not found to be statistically significantly related (p-value>0.05).
The present study, applied to a substantial sample of Italian population, demonstrates that there are peculiar risk factors for spontaneous PTB in the Italian population examined. It shows an association between preterm delivery and certain maternal factors as: BMI, employment, previous abortions, previous PTBs and previous cesarean section.
本研究旨在比较自发性早产（PTB）与足月分娩的产妇危险因素，以识别高危产妇，并对意大利的整体情况进行概述。
本研究采用多中心、观察性、回顾性、横断面研究设计。研究人群包括在意大利 9 家不同大学妇产科医院招募的 7634 名女性。主要纳入标准为：在研究期间，每位参与中心的女性均有阴道早产或足月自发性分娩。记录与 2008 年 4 月至 12 月期间发生的分娩相关。采用多变量逻辑回归分析确定自发性早产的独立预测因素。比值比（ORs）和 95%置信区间（95%CI）用双侧概率（p）值报告。使用 SAS 版本 9.1 进行统计计算。双侧 p 值<0.05 定义为统计学显著结果。
BMI>25（OR=1.662；95%CI=1.033-2.676；p 值=0.0365）和从事重体力劳动的女性（OR=1.947；95%CI=1.182-3.207；p 值=0.0089）发生 PTB 的风险显著增加。此外，PTB 与既往生育史之间存在显著关联。事实上，既往流产史（OR=1.954；95%CI=1.162-3.285；p 值=0.0116）或既往剖宫产史（OR=2.904；95%CI=1.066-7.910；p 值=0.0371）与 PTB 风险增加呈正相关，且 PTB 与既往早产之间存在重要的统计学显著关联（OR=3.412；95%CI=1.342-8.676；p 值=0.0099）。作为 PTB 的潜在危险因素，所有其他检查的协变量均未显示出统计学显著相关性（p 值>0.05）。
本研究应用于意大利的大量人群样本，表明意大利人群存在自发性早产的特殊危险因素。它显示了早产与某些产妇因素之间的关联，如 BMI、就业、既往流产史、既往早产史和既往剖宫产史。
