Spain Janine E, Tuuli Methodius, Caughey Aaron B, Roehl Kimberly A, Zhao Qiuhong, Cahill Alison G
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.
Am J Perinatol. 2014 Apr;31(4):315-20. doi: 10.1055/s-0033-1348951. Epub 2013 Jun 17.
To compare first-stage labor patterns in women in preterm labor to those in labor at term.
We performed a retrospective cohort study of consecutive women admitted from 2004 to 2008 with viable (≥ 24 weeks) vertex singleton gestations who reached the second stage of labor. Labor curves for preterm and term labor were created using a repeated-measures analysis with polynomial modeling. Interval-censored regression was used to estimate and compare median time of progression of labor. Multivariable analyses were performed to adjust for smoking, obesity (body mass index ≥ 30), induction, and nulliparity. The adjusted model was stratified by parity and induction of labor.
Of 5,612 consecutive births, 224 were preterm (<37 weeks) and 5,388 were term (≥ 37 weeks). Preterm first-stage labor progressed significantly faster than term labor (median time 4 to 10 cm: 3.3 hours versus 4.5 hours, p < 0.01). When stratified by parity, preterm labor progressed significantly more rapidly than term labor in both nulliparous and multiparous women (median time 4 to 10 cm: 3.7 hours versus 4.9 hours [p = 0.04] in nulliparous women and 2.5 hours versus 4.3 hours [p = 0.01] in multiparous women).
Women in preterm labor progress more rapidly through the first stage of labor than women at term.
比较早产妇女与足月分娩妇女的第一产程模式。
我们对2004年至2008年收治的连续妊娠且胎儿存活（≥24周）、单胎头位并进入第二产程的妇女进行了一项回顾性队列研究。使用多项式建模的重复测量分析创建早产和足月分娩的产程曲线。采用区间删失回归来估计和比较产程进展的中位时间。进行多变量分析以校正吸烟、肥胖（体重指数≥30）、引产和初产情况。校正模型按产次和引产情况进行分层。
在5612例连续分娩中，224例为早产（<37周），5388例为足月产（≥37周）。早产的第一产程进展明显快于足月产（4至10厘米的中位时间：3.3小时对4.5小时，p<0.01）。按产次分层时，初产妇和经产妇中早产的进展均明显快于足月产（4至10厘米的中位时间：初产妇为3.7小时对4.9小时[p=0.04]，经产妇为2.5小时对4.3小时[p=0.01]）。
早产妇女第一产程的进展比足月产妇女更快。
