Kuzniewicz Michael W, Black Libby, Walsh Eileen M, Li Sherian X, Greenberg Mara
Division of Research, Kaiser Permanente Northern California, Oakland, California.
Division of Neonatology, Kaiser Permanente Northern California, San Francisco, California.
AJP Rep. 2017 Apr;7(2):e106-e113. doi: 10.1055/s-0037-1603911. Epub 2017 Jun 22.
This study aims to quantitate the incidence of preterm labor (PTL) admissions and determine the frequency and predictors of preterm delivery (PTD) during these admissions. Retrospective cohort of singleton pregnancies within Kaiser Permanente Northern California, 2001 to 2011. PTL admissions were defined as inpatient encounters > 24 hours with an International Classification of Diseases, 9th Revision code for PTL. Total study population was 365,897 with PTL admission rate 11%. PTD occurred in 85% of pregnancies with PTL admission. Delivery occurred within 48 hours of admission in 96% ≥34 weeks, 67% 31 to 33 weeks, and 51.9% <31 weeks. Predictors of delivery during PTL admission included gestational age 34 to 36 weeks (adjusted odds ratio [aOR], 6.90), chorioamnionitis (aOR, 105.58), and preterm rupture of membranes (aOR 19.29). We demonstrate a high rate of PTD per PTL admission in a highly integrated health care system. More work is needed to determine optimal practices for hospitalization and treatment of women diagnosed with PTL.
本研究旨在对早产（PTL）入院发生率进行定量分析，并确定这些入院期间早产（PTD）的频率及预测因素。
对2001年至2011年加利福尼亚州北部凯撒医疗集团内的单胎妊娠进行回顾性队列研究。PTL入院定义为住院时间超过24小时且国际疾病分类第九版中有PTL编码的住院病例。
研究总人群为365,897例，PTL入院率为11%。85%的PTL入院妊娠发生了PTD。孕周≥34周的患者中，96%在入院后48小时内分娩；孕周31至33周的患者中，67%在入院后48小时内分娩；孕周<31周的患者中，51.9%在入院后48小时内分娩。PTL入院期间分娩的预测因素包括孕34至36周（调整优势比[aOR]，6.90）、绒毛膜羊膜炎（aOR，105.58）和胎膜早破（aOR，19.29）。
我们发现在一个高度整合的医疗保健系统中，每次PTL入院的PTD发生率很高。需要开展更多工作来确定诊断为PTL的女性住院治疗的最佳方案。
