2010年法国早产的风险因素及自1995年以来的变化：法国国家围产期调查结果

Risk factors of preterm birth in France in 2010 and changes since 1995: Results from the French National Perinatal Surveys.

作者信息

Prunet C, Delnord M, Saurel-Cubizolles M-J, Goffinet F, Blondel B

机构信息

Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, 75014Paris, France; Maternité Port-Royal, Paris Descartes University, Cochin Broca Hôtel-Dieu Hospital, AP-HP, DHU Risks in pregnancy, 75014 Paris, France.

出版信息

J Gynecol Obstet Hum Reprod. 2017 Jan;46(1):19-28. doi: 10.1016/j.jgyn.2016.02.010. Epub 2016 Apr 5.

DOI:10.1016/j.jgyn.2016.02.010

PMID:28403953

Abstract

OBJECTIVES

To investigate risk factors of total, spontaneous and induced preterm birth in 2010 and differences between 1995 and 2010.

MATERIAL AND METHODS

The national perinatal surveys are based on a representative sample of births in France. We selected live-born singletons (n=14,326 in 2010 and 12,885 in 1995) and used multiple regression analyses to calculate adjusted odds ratios (aOR) for maternal sociodemographic characteristics, obstetric history, prenatal care and smoking.

RESULTS

The main risk factors in 2010 were parity 1 compared to parity 2 (aOR=1.9 [95% CI 1.5-1.3]), previous preterm delivery (aOR=6.6 [5.0-8.7]), pre-pregnancy body mass index<18.5 compared to 18.5-24.9kg/m (aOR=1.7 [1.4-2.2]), level of education completed: high school or less, inadequate prenatal care and cannabis use. Most risk factors of spontaneous and induced preterm births were similar. Compared to 1995, maternal age≥35 years and previous induced abortion were no longer associated with preterm birth in 2010.

CONCLUSION

Identified risk factors for preterm birth in France in 2010 agree with the literature. Increases in baseline rates for maternal age and medically induced abortions may explain changes in certain preterm birth risk factors.

摘要

目的

调查2010年足月、自然早产和人工早产的危险因素以及1995年与2010年之间的差异。

材料与方法

全国围产期调查基于法国具有代表性的出生样本。我们选取了活产单胎（2010年为14326例，1995年为12885例），并使用多元回归分析来计算孕产妇社会人口学特征、产科病史、产前护理和吸烟情况的调整比值比（aOR）。

结果

2010年的主要危险因素包括与经产2次相比经产1次（aOR = 1.9 [95% CI 1.5 - 1.3]）、既往早产（aOR = 6.6 [5.0 - 8.7]）、孕前体重指数<18.5与18.5 - 24.9kg/m相比（aOR = 1.7 [1.4 - 2.2]）、完成的教育水平：高中及以下、产前护理不足和使用大麻。自然早产和人工早产的大多数危险因素相似。与1995年相比，2010年孕产妇年龄≥35岁和既往人工流产不再与早产相关。