INSIDE Research Group Department of Pediatrics Universidad del Valle, University Hospital of Valle, Cali, Colombia.
Department of Pediatrics, University Hospital of Valle, Cali, Colombia.
Front Public Health. 2020 Jul 10;8:200. doi: 10.3389/fpubh.2020.00200. eCollection 2020.
The birth rate of late premature babies has been increasing in recent years, composing now 75% of all premature births. This growing trend can be explained by different demographic transformations such as an increase in the demand for infertility treatments, older maternal age and the higher incidence of multiple pregnancies, cesarean sections, and labor induction. These premature babies contribute 30% to the global neonatal mortality rate. To identify the factors associated with late prematurity at the Hospital Universitario del Valle during the years 2013-2014. Case and control design, 424 patients, 212 cases and 212 controls participated. Cases were defined as newborns with gestational age between 34 and 36 weeks and 6 days old. For the analysis, logistic regression models were developed and association forces (OR) were determined. A univariate analysis shows that the proportion of teenage pregnant women corresponds to 22.64%. Bivariate analysis shows the maternal morbidity due to hypertensive disorders was 1.6 times higher (95% CI 1.06-2.63), the obstetric alterations in 2.9 times (CI of 95% 1.56-5.44), late preterm infants require more oxygen support 3.26 times (95% CI 1.76-6.03). After adjusting the model, it was found that late premature infants have a 3-fold probability of requiring some resuscitation maneuver (ORa 3.23 95% CI 2.09-4.99), birth is higher by cesarean section by 4.17 times (ORa 4.17 IC 95% 2.50-6.98), maternal morbidity was higher in 1.37 times (ORa 1.37 95% CI 1.14-1.65). The morbidity of the newborn was greater, close to the statistical significance for late premature infants in 1.26 times (ORa 1.26 95% CI 0.97-1.64). Late premature births in this study show a higher probability of developing morbidity, have a greater opportunity to be born by cesarean section, are products of mothers with morbidity (specifically hypertensive disorders), and require further resuscitation with a need of early obstetric intervention.
近年来,晚期早产儿的出生率一直在上升,现在占所有早产儿的 75%。这种增长趋势可以通过不同的人口统计学变化来解释,如不孕症治疗需求的增加、产妇年龄的增长以及多胎妊娠、剖腹产和引产的发生率增加。这些早产儿占全球新生儿死亡率的 30%。
在 2013-2014 年期间,确定在 Valle 大学医院与晚期早产相关的因素。
病例对照设计,共有 424 名患者,212 例病例和 212 例对照参与。病例定义为胎龄在 34 至 36 周加 6 天之间的新生儿。对于分析,开发了逻辑回归模型并确定了关联力(OR)。
单变量分析表明,青少年孕妇的比例为 22.64%。双变量分析表明,高血压疾病引起的产妇发病率高 1.6 倍(95%CI 1.06-2.63),产科改变高 2.9 倍(95%CI 1.56-5.44),晚期早产儿需要更多的氧气支持 3.26 倍(95%CI 1.76-6.03)。在调整模型后,发现晚期早产儿需要进行某种复苏操作的可能性增加了 3 倍(调整后 ORa 3.23,95%CI 2.09-4.99),剖宫产分娩的概率增加了 4.17 倍(调整后 ORa 4.17,95%CI 2.50-6.98),产妇发病率高 1.37 倍(调整后 ORa 1.37,95%CI 1.14-1.65)。新生儿发病率更高,接近晚期早产儿的统计学意义,为 1.26 倍(调整后 ORa 1.26,95%CI 0.97-1.64)。
本研究中的晚期早产儿发病的可能性更高,更有可能通过剖腹产分娩,是患有疾病(特别是高血压疾病)的母亲的产物,需要进一步复苏,需要早期产科干预。