School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
PLoS One. 2013 Dec 17;8(12):e84237. doi: 10.1371/journal.pone.0084237. eCollection 2013.
To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility.
A retrospective cohort study.
Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis.
Women diagnosed with infertility respectively had 1.39 (95% CI, 1.061.83), 1.15 (95% CI, 1.081.24), 1.13 (95% CI, 1.081.18), and 1.08 (95% CI, 1.051.12) higher odds of having very low birth weight (VLBW) babies, preterm births, labor complications, and cesarean sections (CSs) compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care.
Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.
探究各种产前护理措施对有不孕史女性不良妊娠结局的影响。
回顾性队列研究。
本研究通过链接两个大型全国性基于人群的数据集(全民健康保险研究数据库和台湾出生证明登记处)获取数据。研究样本包括 15056 名被诊断为不孕的女性和 60224 名随机选择的与研究样本按母体年龄匹配的无不孕史的女性。采用条件逻辑回归分析进行分析。
与无不孕史的女性相比,被诊断为不孕的女性分别具有 1.39(95%CI,1.061.83)、1.15(95%CI,1.081.24)、1.13(95%CI,1.081.18)和 1.08(95%CI,1.051.12)更高的极低出生体重儿(VLBW)、早产、分娩并发症和剖宫产(CS)发生风险。产前检查总次数和主要次数不足以及产前护理开始时间晚增加了不孕女性不良妊娠结局的风险,尤其是 VLBW 儿的风险。然而,与有足够产前护理的有生育能力的女性相比,有足够产前护理的不孕女性不良出生结局的风险并无显著相关性。
研究结果表明,充足的产前护理可以降低不孕女性不良妊娠结局的风险。