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日本早产复发风险的回顾性研究。

Retrospective study of the recurrence risk of preterm birth in Japan.

作者信息

Seyama Rie, Makino Shintaro, Nojiri Shuko, Takeda Jun, Suzuki Toshifumi, Maruyama Yojiro, Takeda Satoru, Itakura Atsuo

机构信息

Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.

Medical Technology Innovation Center, Juntendo University, Tokyo, Japan.

出版信息

J Matern Fetal Neonatal Med. 2022 Feb;35(3):515-519. doi: 10.1080/14767058.2020.1727435. Epub 2020 Feb 18.

Abstract

BACKGROUND

A history of preterm birth is a risk factor for preterm birth in a future pregnancy, and there are some reports of prevention methods, such as the administration of progesterone. However, the rate of recurrence of preterm birth in Japan has not been clarified, and there is no data for judging whether these preventive methods are effective.

OBJECTIVE

To clarify the risk of recurrence of preterm birth and preterm prelabor rupture of membranes (pPROM) in Japan.

MATERIALS AND METHODS

A retrospective study was conducted using the perinatal registration database of the Japan Obstetrics and Gynecology Society for the Perinatal Center from 2014 to 2016. There were 704,418 subjects, of which 190,990 were excluded those with unknown maternal information, those under the age of 20 years, those with perinatal disease related to preterm birth, and first-time mothers.

RESULTS

Logistic model unavailable and multivariate analysis were performed. An analysis of the preterm birth history indicated the risk of preterm birth in the current pregnancy, and the odds ratio for preterm birth recurrence once, twice, and three times or more was 3.3, 6.6, and 7.8, respectively. As a secondary analysis, we analyzed whether the history of pPROM is a risk factor of recurrence of pPROM and found a significant association with an odds ratio of 3.4.

CONCLUSION

Having a preterm birth history increases the risk of recurrence of preterm birth, and the risk of recurrent preterm birth increases as the number of preterm births increases. Although this report is intended for high-risk pregnancies wherein the rate of preterm birth is high, as previously reported, our data indicate that in Japan, preterm birth is a risk factor of recurrent preterm birth.

摘要

背景

早产史是未来妊娠发生早产的一个风险因素,并且有一些关于预防方法的报道,比如使用黄体酮。然而,日本早产的复发率尚未明确,也没有用于判断这些预防方法是否有效的数据。

目的

明确日本早产和胎膜早破早产(pPROM)复发的风险。

材料与方法

利用日本妇产科学会围产期中心2014年至2016年的围产期登记数据库进行一项回顾性研究。共有704418名受试者,其中190990名被排除,包括孕产妇信息不明者、20岁以下者、与早产相关的围产期疾病患者以及初产妇。

结果

进行了逻辑模型不可用和多变量分析。对早产史的分析表明了当前妊娠早产的风险,早产复发一次、两次以及三次及以上的优势比分别为3.3、6.6和7.8。作为一项次要分析,我们分析了pPROM史是否是pPROM复发的一个风险因素,发现二者存在显著关联,优势比为3.4。

结论

有早产史会增加早产复发的风险,且复发早产的风险随着早产次数的增加而增加。尽管本报告针对的是早产率较高的高危妊娠,正如之前所报道的那样,但我们的数据表明,在日本,早产是复发早产的一个风险因素。

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