Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Int J Gynaecol Obstet. 2018 Jan;140(1):81-86. doi: 10.1002/ijgo.12348. Epub 2017 Nov 6.
To evaluate associations between a history of spontaneous abortion and preterm delivery during subsequent pregnancies.
The present secondary analysis included cross-sectional survey data related to all deliveries at 103 hospitals in Tehran, Iran, between July 6 and 21, 2015. Trained midwives interviewed patients within 24 hours of delivery. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to investigate associations between spontaneous abortion and preterm delivery.
Data were included from 4991 deliveries. A history of spontaneous abortion (OR 1.50, 95% CI 1.21-1.87; P=0.001) and history of recurrent spontaneous abortion (OR 3.74, 95% CI 1.90-7.37; P=0.001) were associated with increased odds of preterm delivery in comparison with no such history. Similarly, one (OR 1.33, 95% CI 1.04-1.70; P=0.023), two (OR 1.78, 95% CI 1.15-2.74; P=0.009), or at least three prior spontaneous abortions (OR 4.10, 95% CI 2.08-8.08; P=0.001) were associated with increased odds of preterm delivery compared with none. Population attributable fractions of 9.49% (95% CI 3.36-15.12) and 2.00% (95% CI 0.57-3.56) were calculated for histories of spontaneous abortion and recurrent pregnancy loss, respectively.
History of spontaneous abortion and history of recurrent pregnancy loss were associated with increased odds of preterm delivery. A greater number of spontaneous abortions corresponded to greater odds of preterm delivery.
评估自然流产史与随后妊娠中早产的相关性。
本研究为二次分析，纳入了 2015 年 7 月 6 日至 21 日在伊朗德黑兰 103 家医院所有分娩的横断面调查数据。培训过的助产士在分娩后 24 小时内对患者进行访谈。计算调整后的比值比（OR）及其 95%置信区间（CI），以调查自然流产与早产之间的相关性。
共纳入 4991 例分娩。与无自然流产史相比，有自然流产史（OR 1.50，95%CI 1.21-1.87；P=0.001）和复发性自然流产史（OR 3.74，95%CI 1.90-7.37；P=0.001）与早产风险增加相关。同样，与无自然流产史相比，有一次（OR 1.33，95%CI 1.04-1.70；P=0.023）、两次（OR 1.78，95%CI 1.15-2.74；P=0.009）或至少三次自然流产史（OR 4.10，95%CI 2.08-8.08；P=0.001）与早产风险增加相关。自然流产史的人群归因分数为 9.49%（95%CI 3.36-15.12），而复发性妊娠丢失史的人群归因分数为 2.00%（95%CI 0.57-3.56）。
自然流产史和复发性妊娠丢失史与早产风险增加相关。自然流产次数越多，早产风险越高。
