前置胎盘导致早产的风险因素。

Risk factors for preterm delivery with placenta previa.

机构信息

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA.

出版信息

J Perinat Med. 2011 Nov 16;40(1):39-42. doi: 10.1515/JPM.2011.125.

DOI:10.1515/JPM.2011.125

PMID:22085154

Abstract

AIMS

To identify factors associated with preterm delivery in cases of sonographically identified placenta previa.

METHODS

Pregnancies with sonographic evidence of placenta previa at ≥ 28 weeks were identified. Demographic information, antepartum course, and delivery information were extracted from electronic medical records. Statistical analysis was performed with Fisher's exact test, Mann-Whitney U, Spearman's ρ (correlation), and logistic regression. Continuous data are presented as median (interquartile range).

RESULTS

Of 113 singleton pregnancies with placenta previa, 54 (48%) delivered at term and 59 (52%) delivered preterm. Fifty-one (45%) experienced antepartum bleeding at a median gestational age of 31 weeks (29-33 weeks) with a median interval of 20 days (11-33 days) between first bleeding episode and delivery. Women with antepartum bleeding were more likely to be delivered for hemorrhage (36 of 51 vs. 8 of 62, P<0.001) and delivered emergently (40 of 51 vs. 14 of 62, P<0.001). Antepartum bleeding before 34 weeks had a positive predictive value of 88% for preterm birth and 83% for emergent delivery.

CONCLUSION

In pregnancies with placenta previa, antepartum bleeding is a strong predictor of preterm delivery.

摘要

目的

确定与经超声诊断为前置胎盘的早产病例相关的因素。

方法

确定在≥28 周时经超声检查发现前置胎盘的妊娠。从电子病历中提取人口统计学信息、产前过程和分娩信息。采用 Fisher 确切检验、Mann-Whitney U 检验、Spearman ρ（相关性）和逻辑回归进行统计分析。连续数据表示为中位数（四分位距）。

结果

在 113 例单胎前置胎盘妊娠中，54 例（48%）足月分娩，59 例（52%）早产。51 例（45%）在中位孕龄 31 周（29-33 周）时发生产前出血，第一次出血事件与分娩之间的中位间隔为 20 天（11-33 天）。有产前出血的妇女更有可能因出血（51 例中的 36 例与 62 例中的 8 例，P<0.001）和紧急分娩（51 例中的 40 例与 62 例中的 14 例，P<0.001）而分娩。在 34 周前发生的产前出血对早产和紧急分娩的阳性预测值分别为 88%和 83%。