Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China.
Department of Health Management and Policy, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China.
Chin Med J (Engl). 2017 Oct 5;130(19):2307-2315. doi: 10.4103/0366-6999.215341.
Preterm birth is a common cause of death in newborns and may result from many determinants, but evidence for the socioeconomic and environmental determinants of preterm birth in Tibetan women of childbearing age is limited. The aim of this study was to understand the current status of preterm birth in native Tibetan women and investigate the socioeconomic and environmental determinants.
Data were drawn from a cohort study which was conducted from August 2006 to August 2012 in rural Lhasa, Tibet, China. A total of 1419 Tibetan pregnant women were followed from 20 weeks' gestation until delivery; the loss to follow-up rate was 4.69%. The incidence of preterm birth was estimated to show the status of preterm births in Tibet. Logistic regression models for longitudinal data were established, and odds ratios (ORs) together with 95% confidence intervals (CIs) were used to evaluate the association between the occurrence of preterm birth and 16 selected potential determinants based on the hierarchical conceptual frame.
The incidence of preterm birth was 4.58% (95% CI = 3.55-5.80%). After adjusting for health-related variables of the mothers and newborns, socioeconomic and environmental determinants associated with preterm birth included season (spring: OR = 0.28, 95% CI = 0.09-0.84; autumn: OR = 0.21, 95% CI = 0.06-0.69; and winter: OR = 0.31, 95% CI = 0.12-0.82) and calendar year of delivery (2010: OR = 5.03, 95% CI = 1.24-20.35; 2009: OR = 6.62, 95% CI = 1.75-25.10; and 2007-2008: OR = 5.93, 95% CI = 1.47-23.90).
The incidence of preterm birth among native Tibetan women was low and there was a decreasing trend in recent years; however, it is still essential to strengthen seasonal maternal care, extend the spacing between pregnancies, and reinforce adequate maternal nutrition.
早产是新生儿死亡的常见原因，可能由多种决定因素导致，但藏族育龄妇女早产的社会经济和环境决定因素的证据有限。本研究旨在了解本地藏族妇女早产的现状，并调查社会经济和环境决定因素。
数据来自于 2006 年 8 月至 2012 年 8 月在中国拉萨农村进行的队列研究。共有 1419 名藏族孕妇从 20 周妊娠开始随访至分娩；失访率为 4.69%。早产发生率的估计表明了西藏的早产现状。建立了纵向数据的逻辑回归模型，并使用优势比（OR）及其 95%置信区间（CI），根据分层概念框架，基于 16 个选定的潜在决定因素评估早产发生与这些因素之间的关系。
早产发生率为 4.58%（95%CI=3.55-5.80%）。在调整母亲和新生儿的健康相关变量后，与早产相关的社会经济和环境决定因素包括季节（春季：OR=0.28，95%CI=0.09-0.84；秋季：OR=0.21，95%CI=0.06-0.69；冬季：OR=0.31，95%CI=0.12-0.82）和分娩的历年（2010 年：OR=5.03，95%CI=1.24-20.35；2009 年：OR=6.62，95%CI=1.75-25.10；2007-2008 年：OR=5.93，95%CI=1.47-23.90）。
本地藏族妇女的早产发生率较低，近年来呈下降趋势；但仍有必要加强季节性孕产妇保健，延长生育间隔，加强孕产妇营养。
