Maternal and Fetal Medicine Division, UAB Department of Obstetrics & Gynecology, 1700 6th Avenue South, Women & Infants Center, Room 10270, Birmingham, AL 35233, USA.
Obstet Gynecol Clin North Am. 2012 Mar;39(1):89-97. doi: 10.1016/j.ogc.2011.12.002. Epub 2012 Jan 4.
The frequency of early term birth varies depending on patient, provider, and system characteristics. Early term deliveries are associated with suboptimal neonatal outcomes without evidence of maternal benefit. Some early term births are either unavoidable or absolutely indicated for maternal and/or fetal benefit in the setting of medical or obstetric risks. Demonstrated fetal lung maturity before early term birth reduces the risk of respiratory and other morbidities relative to gestational age-matched counterparts but may not reduce the risks to the low levels at 39 to 40 weeks. For some risk situations, it remains controversial whether earlier delivery is beneficial. The assessment of the provider and patient’s desires should direct care. In the absence of any obstetric or medical risks, early term delivery should be avoided. A simple intervention that includes administrative support, review of indications, and feedback to providers can dramatically reduce the frequency of early term births over time.
早产的频率因患者、提供者和系统特征而异。早产与新生儿结局不理想有关，而没有证据表明对母亲有好处。在存在医疗或产科风险的情况下，一些早产要么是不可避免的，要么是绝对为了母亲和/或胎儿的利益而进行的。在早产前证明胎儿肺部成熟可降低与胎龄相匹配的早产儿相比的呼吸和其他发病率的风险，但可能不会将风险降低到 39 至 40 周的低水平。对于某些风险情况，是否更早分娩有益仍存在争议。提供者和患者的愿望评估应指导护理。在没有任何产科或医学风险的情况下，应避免早产。一项简单的干预措施，包括行政支持、对指征的审查和向提供者提供反馈，可以随着时间的推移显著降低早产的频率。
