Koullali B, Oudijk M A, Nijman T A J, Mol B W J, Pajkrt E
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands.
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands.
Semin Fetal Neonatal Med. 2016 Apr;21(2):80-8. doi: 10.1016/j.siny.2016.01.005. Epub 2016 Feb 18.
Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers.
早产是全球新生儿死亡和发病的最重要原因。在本综述中，我们回顾了与早产相关的潜在风险因素以及对单胎或多胎妊娠的低风险和高风险女性预防早产的后续管理措施。早产史被认为是后续妊娠早产的最重要风险因素。影响较小的一般风险因素包括种族、社会经济地位低、孕妇体重、吸烟和牙周状况。与妊娠相关的特征，包括细菌性阴道病和无症状菌尿，在早产预测中的价值似乎有限。相比之下，孕中期宫颈长度测量与早产独立相关，可用于识别有早产风险的女性。胎儿纤连蛋白检测在早产预测中可能具有额外价值。预防早产的最有效方法取决于产科病史，这使得识别有早产风险的女性成为临床护理人员的一项重要任务。
