超声测量宫颈长度、阴道出血与早产风险。

Sonographic cervical length, vaginal bleeding, and the risk of preterm birth.

机构信息

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

出版信息

Am J Obstet Gynecol. 2012 Mar;206(3):224.e1-4. doi: 10.1016/j.ajog.2011.10.879. Epub 2011 Nov 7.

DOI:10.1016/j.ajog.2011.10.879

PMID:22133802

Abstract

OBJECTIVE

We sought to evaluate the contributions of vaginal bleeding and cervical length to the risk of preterm birth.

STUDY DESIGN

This was a secondary analysis of a cohort study designed to study predictors of preterm birth. The study included 2988 women with singleton gestations. Women underwent midtrimester transvaginal ultrasound assessment of cervical length and were queried regarding first- and second-trimester vaginal bleeding.

RESULTS

There was a significant second-order relation between cervical length and preterm birth (P < .001, P = .005). Women with vaginal bleeding were at higher risk of preterm birth (odds ratio, 1.5; 95% confidence interval, 1.3-2.0). There was a significant interaction between cervical length and vaginal bleeding (P = .015). After accounting for cervical length and interaction, the adjusted odds ratio for vaginal bleeding and preterm birth was 4.8 (95% confidence interval, 1.89-12.4; P = .001).

CONCLUSION

The magnitude of risk of preterm birth associated with sonographic cervical length depends on a woman's history of first- and second-trimester vaginal bleeding.

摘要

目的

我们旨在评估阴道出血和宫颈长度对早产风险的影响。

研究设计

这是一项旨在研究早产预测因素的队列研究的二次分析。该研究纳入了 2988 名单胎妊娠女性。在妊娠中期，女性接受经阴道超声评估宫颈长度，并被询问第一和第二孕期阴道出血的情况。

结果

宫颈长度与早产之间存在显著的二阶关系（P<.001，P=.005）。有阴道出血的女性早产风险更高（优势比，1.5；95%置信区间，1.3-2.0）。宫颈长度和阴道出血之间存在显著的交互作用（P=.015）。在考虑宫颈长度和交互作用后，阴道出血和早产的调整后优势比为 4.8（95%置信区间，1.89-12.4；P=.001）。