Ochrem Dagna, Kaim Irena, Majewska Renata, Jaworowski Andrzej, Sowa Agata, Jędrychowski Wiesław
Przegl Lek. 2015;72(7):343-8.
The occurrence of preterm labor is the cause of 75% of preterm births. Prematurity is the leading cause of mortality of children under four weeks of age. Tocolytic drugs are used widely in the treatment of preterm labor. The aim of this study was to assess the impact of the tocolytic therapy on obstetric and neonatal outcomes.
The prospective, cohort study included 499 pregnant women The study enrolled women who met certain criteria of age, with singleton pregnancy, having no chronic diseases. After delivery the following data were obtained: sociodemographic profile (including data on occupational activity), body height and weight before pregnancy, weight gain, duration of pregnancy, mode of delivery, obstetric complications, medications, anthropometric parameters and state of health of newborns. A group of patients treated with tocolytic drugs and a control group were identified. Then obstetric and neonatal outcomes in both groups were subjected to statistical analysis.
There was no statistically significant difference between the two groups in terms of the following variables: mother's age, her education, professional activity of mothers in the first and second trimester of pregnancy, weight gain during pregnancy, parity, exposure to passive smoking during pregnancy, method of pregnancy termination. We found a statistically significant difference between the groups with respect to maternal weight before pregnancy (lower in the group using tocolytics), the average duration of pregnancy (lower in the group using tocolytics), the frequency of preterm birth (higher in the group using tocolytics) and neonatal anthropometric parameters and the number of points in the Apgar score at 5 minutes of age (lower in the group using tocolytics).
Low pregestational weight is a risk factor for preterm labor. Term birth rate in pregnant women treated for preterm labor is significantly smaller compared to the general population, which may indicate low efficacy of tocolytic drugs. There was no positive correlation found between the professional activity of pregnant women and the risk of threatening preterm labor.
早产的发生是75%早产病例的原因。早产是四周龄以下儿童死亡的主要原因。宫缩抑制剂被广泛用于治疗早产。本研究的目的是评估宫缩抑制疗法对产科和新生儿结局的影响。
这项前瞻性队列研究纳入了499名孕妇。该研究招募了符合特定年龄标准、单胎妊娠且无慢性病的女性。分娩后获得了以下数据:社会人口统计学特征(包括职业活动数据)、孕前身高和体重、体重增加情况、孕期时长、分娩方式、产科并发症、用药情况、人体测量参数以及新生儿健康状况。确定了一组接受宫缩抑制剂治疗的患者和一个对照组。然后对两组的产科和新生儿结局进行统计分析。
在以下变量方面,两组之间没有统计学上的显著差异:母亲年龄、教育程度、母亲在妊娠第一和第二阶段的职业活动、孕期体重增加、产次、孕期被动吸烟暴露情况、终止妊娠的方法。我们发现两组在孕前母亲体重(使用宫缩抑制剂的组较低)、平均孕期时长(使用宫缩抑制剂的组较短)、早产频率(使用宫缩抑制剂的组较高)、新生儿人体测量参数以及出生后5分钟阿氏评分的得分点数(使用宫缩抑制剂的组较低)方面存在统计学上的显著差异。
孕前体重低是早产的一个风险因素。接受早产治疗的孕妇足月分娩率明显低于一般人群,这可能表明宫缩抑制剂药物疗效较低。未发现孕妇的职业活动与早产威胁风险之间存在正相关。