Walfisch Asnat, Kessous Roy, Davidson Ehud, Sergienko Ruslan, Beharier Ofer, Sheiner Eyal
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Perinatol. 2016 Jun;33(7):708-14. doi: 10.1055/s-0036-1571326. Epub 2016 Feb 13.
Objective Spontaneous preterm deliveries (PTDs) have been consistently associated with maternal vascular complications. We aimed to investigate an association between PTD and subsequent maternal ophthalmic morbidity. Study Design In this population-based cohort study, we included all singleton deliveries occurring between 1988 and 2013. We excluded women with known ophthalmic disease. The exposure was at least one pregnancy with PTD. Outcomes included different maternal ophthalmic morbidity. The cumulative incidence and adjusted hazard ratios were assessed using a Kaplan-Meier survival curve and Cox hazards models. Results Of the 105,018 patients included, 17,600 (16.7%) delivered preterm. Patients with a history of PTD (both induced and spontaneous) had higher rates of ophthalmic complications (odds ratio [OR]: 2.12; confidence interval [CI]: 1.6-2.7; p < 0.001), specifically diabetic retinopathy and glaucoma (OR: 4.79 and 2.48, respectively). A linear association was found between the number of previous PTDs and ophthalmic complications (0.2% for no PTD; 0.4% for one PTD; 0.6% for two or more PTDs; p < 0.001) and for early and late PTD (p < 0.001). A Cox model revealed an independent association between PTD and ophthalmic complications (adjusted hazard ratio: 2.2; 95% CI: 1.6-2.9). Conclusion A history of PTD is an independent risk factor for ophthalmic morbidity.
自发性早产（PTD）一直与母体血管并发症相关。我们旨在研究PTD与随后母体眼部疾病之间的关联。
在这项基于人群的队列研究中，我们纳入了1988年至2013年间发生的所有单胎分娩。我们排除了已知患有眼部疾病的女性。暴露因素为至少有一次PTD妊娠。结局包括不同的母体眼部疾病。使用Kaplan-Meier生存曲线和Cox风险模型评估累积发病率和调整后的风险比。
在纳入的105,018例患者中，17,600例（16.7%）早产。有PTD病史（包括引产和自发性）的患者眼部并发症发生率更高（优势比[OR]：2.12；置信区间[CI]：1.6 - 2.7；p < 0.001），特别是糖尿病视网膜病变和青光眼（分别为OR：4.79和2.48）。发现既往PTD的次数与眼部并发症之间存在线性关联（无PTD为0.2%；一次PTD为0.4%；两次或更多次PTD为0.6%；p < 0.001），以及与早期和晚期PTD之间也存在线性关联（p < 0.001）。Cox模型显示PTD与眼部并发症之间存在独立关联（调整后的风险比：2.2；95% CI：1.6 - 2.9）。
PTD病史是眼部疾病的独立危险因素。
