Szczotka F A, Wiór H
Probl Med Wieku Rozwoj. 1979;8:238-45.
Adverse outcome of the previous pregnancy as a risk factor for the next one has lately been given increased attention. Particular concern has been expressed as to the possible adverse effects of induced abortion on subsequent pregnancy outcome (1, 2, 3, 4, 5, 6). The purpose of the present report was to establish on the basis of population studies whether and to what extent, abnormal outcome of pregnancy increases the risk of abnormal outcome of the next or further pregnancies. Particular attempt was made to evaluate the increased risk of abnormal outcome of pregnancy following spontaneous and induced abortion. A sample of the studied population was originally collected in several Departments of Obstetrics for a study on epidemiology of low birth weight, and its selection was conditioned by that study. The sample included women whose present pregnancy resulted in the delivery of a live born child. This pregnancy was not taken into consideration in the present study except as a basis for selection of 2 study groups of women who previously had at at least 2 pregnancies (except the present one): Group A consisted of 1180 women who gave birth in the recent pregnancy to a full term child weighing over 3000 g and Group B of 1170 women who delivered a low birth weight infant in their previous pregnancy. Mothers of infants weighing between 2500 and 3000 g were also included in this group because the foetal growth tables for Polish newborn infants showed that weight limits at the 5th percentile for full term male infant ranged between 2500-2800 g and below 10th percentile between 2600 and 3000 g. The following outcomes of previous pregnancies were considered: Full term newborn infant (FT) Low birth weight infant (less than or equal to 2500 g) (Pr) Spontaneous abortion (SA) Induced abortion (IA) Other outcomes (O) Contingency tables containing information on the frequency of different outcomes of earlier and later pregnancies were prepared and the effects of the mode of termination of the earlier pregnancy on the later ones were demonstrated. Interrupted pregnancies were not included in the whole number of cases for the calculation of the percent value, as the decision to interrupt is usually arbitrary and very seldom related to the outcome of the previous pregnancy. The differences between the distribution of pregnancy outcomes in various categories of termination of earlier pregnancy were tested by standard Chi square test which was useful also for testing the dependence of the mode of outcome of the preceding and the following pregnancy. The relative risk coefficient was also calculated for two different combinations of outcomes.(ABSTRACT TRUNCATED AT 400 WORDS)
既往妊娠的不良结局作为下一胎的危险因素最近受到了更多关注。人们尤其关注人工流产对后续妊娠结局可能产生的不良影响(1, 2, 3, 4, 5, 6)。本报告的目的是基于人群研究确定妊娠异常是否以及在何种程度上会增加下一胎或后续妊娠出现异常结局的风险。特别尝试评估自然流产和人工流产后妊娠出现异常结局的风险增加情况。研究人群的样本最初是在几个产科收集的,用于一项低出生体重流行病学研究,其选择受该研究的限制。样本包括目前妊娠分娩出活产婴儿的女性。在本研究中,本次妊娠除作为选择两组至少有过2次妊娠(本次妊娠除外)女性的基础外,未被纳入考虑:A组由1180名近期妊娠分娩出体重超过3000克足月婴儿的女性组成,B组由1170名上次妊娠分娩出低出生体重婴儿的女性组成。体重在2500克至3000克之间婴儿的母亲也被纳入该组,因为波兰新生儿的胎儿生长图表显示,足月男婴第5百分位数的体重限制在2500 - 2800克之间,第10百分位数以下在2600克至3000克之间。考虑了既往妊娠的以下结局:足月新生儿(FT)、低出生体重婴儿(小于或等于2500克)(Pr)、自然流产(SA)、人工流产(IA)、其他结局(O)。编制了包含早期和晚期妊娠不同结局频率信息的列联表,并展示了早期妊娠终止方式对后期妊娠的影响。在计算百分比值时,中断妊娠未被纳入病例总数,因为中断妊娠的决定通常是任意的,而且很少与既往妊娠的结局相关。通过标准卡方检验来检验早期妊娠不同终止类别中妊娠结局分布的差异,该检验也有助于检验前次和后续妊娠结局方式之间的相关性。还针对两种不同的结局组合计算了相对风险系数。(摘要截断于400字)