Boivin Ariane, Luo Zhong-Cheng, Audibert François, Mâsse Benoit, Lefebvre Francine, Tessier Réjean, Nuyt Anne Monique
Departments of Paediatrics, Obstetrics and Gynaecology, and Social and Preventive Medicine, Sainte-Justine University Hospital and Research Center, University of Montreal, Montreal, and the School of Psychology, Laval University, Québec City, Québec, Canada.
Obstet Gynecol. 2015 May;125(5):1177-1184. doi: 10.1097/AOG.0000000000000813.
To evaluate whether women who themselves were born preterm are at increased risk of preterm delivery and, if so, whether known maternal complications of preterm birth such as hypertension or diabetes explain this risk.
We conducted a population-based cohort study of all women born preterm (51,148) and term (823,991) in Québec, Canada, between 1976 and 1995; after frequency matching 1:2 preterm to term, we examined the relationship of preterm birth between women and their offspring.
The study included 7,405 women who were born preterm (554 before 32 weeks of gestation and 6,851 at 32-36 weeks of gestation) and 16,714 women born term, who delivered 12,248 and 27,879 newborns, respectively. Overall, 14.2% of women born before 32 weeks of gestation, 13.0% of 32-36 weeks of gestation, and 9.8% of those born term delivered prematurely at least once during the study period, including 2.4%, 1.8%, and 1.2%, respectively, who delivered very preterm (both P<.001 for trend). After adjustment for factors including own birth weight for gestational age and pregnancy complications, the overall odds of preterm first live delivery associated with being born preterm was elevated by 1.63-fold (95% confidence interval [CI] 1.22-2.19) for women born before 32 weeks of gestation and 1.41-fold (95% CI 1.27-1.57) for those born at 32-36 weeks of gestation relative to women born term.
Women who themselves were born preterm are at increased risk of delivering their neonates prematurely. This is independent of prematurity risks associated with hypertension and diabetes.
II.
评估早产出生的女性是否有更高的早产风险，如果是，早产已知的母体并发症（如高血压或糖尿病）是否能解释这种风险。
我们对1976年至1995年期间在加拿大魁北克出生的所有早产（51,148例）和足月产（823,991例）女性进行了一项基于人群的队列研究；在将早产与足月产按1:2进行频率匹配后，我们研究了女性与其后代早产之间的关系。
该研究纳入了7,405例早产出生的女性（554例在妊娠32周前，6,851例在妊娠32 - 36周）和16,714例足月产出生的女性，她们分别分娩了12,248例和27,879例新生儿。总体而言，在研究期间，妊娠32周前出生的女性中有14.2%、32 - 36周出生的女性中有13.0%以及足月产出生的女性中有9.8%至少有一次早产，其中分别有2.4%、1.8%和1.2%分娩极早产（趋势检验P均<0.001）。在对包括出生体重与孕周的关系及妊娠并发症在内的因素进行调整后，与足月产出生的女性相比，妊娠32周前出生的女性首次活产早产的总体比值比升高了1.63倍（95%置信区间[CI] 1.22 - 2.19），妊娠32 - 36周出生的女性升高了1.41倍（95% CI 1.27 - 1.57）。
早产出生的女性有更高的早产风险。这与高血压和糖尿病相关的早产风险无关。
II级。
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