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短间隔妊娠与高龄产妇不良生育结局:基于人群的研究。

Short interpregnancy interval and adverse birth outcomes in women of advanced age: a population-based study.

机构信息

Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA.

Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA.

出版信息

Ann Epidemiol. 2018 Sep;28(9):605-611. doi: 10.1016/j.annepidem.2018.06.007. Epub 2018 Jun 22.

Abstract

PURPOSE

Short interpregnancy interval (IPI) has been linked with adverse birth outcomes. However, the association in advanced age women needs further investigation. This study aims to examine the association between short IPI and adverse birth outcomes including preterm birth, post-term birth, low birth weight, and macrosomia, in a population of advanced age U.S. women.

METHODS

The 2016 U.S. public-use natality data was analyzed. Analysis was restricted to women with second-order singleton live births who were ≥35 years at first live birth (n = 46,684). Multinomial logistic regression analysis was used to examine the association between short IPI and adverse birth outcomes.

RESULTS

Short IPI in advanced age women was significantly associated with higher odds of extremely preterm birth (0-5 months IPI: adjusted odds ratio [AOR] = 2.43, 95% confidence interval [CI] = 1.07-5.52; 6-11 months IPI: AOR = 2.17, 95% CI = 1.09-4.31), very preterm birth (0-5 months IPI: AOR = 1.63, 95% CI = 1.04-2.56), and extremely low birth weight (0-5 months IPI: AOR = 2.43, 95% CI = 1.28-4.60) in the second delivery. An inverse relationship between short IPI and post-term birth was observed and no significant association between short IPI and macrosomia was found.

CONCLUSIONS

Short IPI in advanced age women increases the odds of adverse birth outcomes in the second delivery.

摘要

目的

短间隔妊娠(IPI)与不良分娩结局有关。然而,高龄妇女的这种关联仍需进一步研究。本研究旨在调查美国高龄妇女中,短 IPI 与不良分娩结局(包括早产、过期产、低出生体重儿和巨大儿)之间的关联。

方法

分析了 2016 年美国公共使用出生数据。分析仅限于首次活产时年龄≥35 岁的二级单胎活产妇女(n=46684)。采用多变量逻辑回归分析来研究短 IPI 与不良分娩结局之间的关系。

结果

高龄妇女的短 IPI 与极高早产(0-5 个月 IPI:调整后的优势比[OR]为 2.43,95%置信区间[CI]为 1.07-5.52;6-11 个月 IPI:OR 为 2.17,95% CI 为 1.09-4.31)、极早产(0-5 个月 IPI:OR 为 1.63,95% CI 为 1.04-2.56)和极低出生体重儿(0-5 个月 IPI:OR 为 2.43,95% CI 为 1.28-4.60)的发生风险显著增加。在第二次分娩中,短 IPI 与过期产呈负相关,与巨大儿无显著关联。

结论

高龄妇女的短 IPI 增加了第二次分娩不良结局的发生风险。

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