Sureshbabu Raveena Pallithazath, Aramthottil Parvathi, Anil Neelanjana, Sumathy Sudha, Varughese Steffi Ann, Sreedevi Aswathy, Sukumaran Sheejamol Velickakathu
Department of Community Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India.
Department of Obstetrics and Gynaecology, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India.
Int J Womens Health. 2021 Apr 9;13:369-377. doi: 10.2147/IJWH.S282251. eCollection 2021.
Preterm delivery is a major obstetric complication and a leading cause of neonatal mortality and morbidity. It is also associated with significant costs in terms of psychological and financial hardship, to the families.
The primary objective of this study was to determine the risk factors associated with all preterm deliveries in singleton pregnancy in a tertiary care hospital and the secondary objective was to determine the fetal outcomes among women with preterm delivery.
A case control study was conducted between January 2019 and June 2019 in the Department of Obstetrics and Gynecology of a tertiary care center in Central Kerala, India. Women who delivered before 37 completed weeks of gestation were taken as cases and those who delivered at or after 37 weeks were considered as controls in a 1:1 ratio, approximately. Data regarding 191 cases and 200 controls were taken from delivery room records of the years 2016 to 2018 with the help of a predesigned checklist. Univariate and multivariate analysis were done to determine the magnitude of association between the exposure factors and preterm delivery.
The mean age of study participants among the cases was 29.3 ± 5.1 years and controls was 28.1 ± 4.4. Pregnancy induced hypertension (aOR = 14.60; 95% CI 4.8, 44.1; p<0.001), abnormal amniotic fluid volume (aOR = 10.68; 95% CI 3.46, 32.98; p<0.001), premature rupture of membranes (PROM) (aOR = 10.27; 95% CI 4.82, 21.86; p<0.001), previous history of preterm delivery (aOR = 4.12; 95% CI 1.22, 13.85; p<0.002), history of urinary tract infection (UTI) during pregnancy (aOR = 3.67; 95% CI 1.39, 9.68; p<0.002), systemic diseases (aOR = 2.78; 95% CI 1.28, 6.39; p<0.001), anaemia (aOR = 2.54; 95% CI 1.28, 5.03; p<0.004) were found to be the independent risk factors for preterm delivery. On analyzing the fetal outcomes, the average birth weight of preterm babies was 2 ± 0.6 kg compared to 3.1kg among term babies.
Early detection and adequate treatment of various conditions like anaemia, pregnancy induced hypertension, UTI and systemic illness can help in reduction of the prevalence of preterm delivery.
早产是一种主要的产科并发症，也是新生儿死亡和发病的主要原因。它还会给家庭带来巨大的心理和经济负担。
本研究的主要目的是确定三级护理医院单胎妊娠中所有早产的相关危险因素，次要目的是确定早产女性的胎儿结局。
2019年1月至2019年6月在印度喀拉拉邦中部一家三级护理中心的妇产科进行了一项病例对照研究。妊娠满37周前分娩的女性作为病例，妊娠37周及以后分娩的女性作为对照，比例约为1:1。借助预先设计的检查表，从2016年至2018年的产房记录中获取了191例病例和200例对照的数据。进行单因素和多因素分析以确定暴露因素与早产之间的关联程度。
病例组研究参与者的平均年龄为29.3±5.1岁，对照组为28.1±4.4岁。妊娠高血压（调整后比值比[aOR]=14.60；95%置信区间[CI]4.8,44.1；p<0.001）、羊水异常（aOR = 10.68；95% CI 3.46,32.98；p<0.001）、胎膜早破（PROM）（aOR = 10.27；95% CI 4.82,21.86；p<0.001）、既往早产史（aOR = 4.12；95% CI 1.22,13.85；p<0.002）、孕期尿路感染（UTI）史（aOR = 3.67；95% CI 1.39,9.68；p<0.002）、全身性疾病（aOR = 2.78；95% CI 1.28,6.39；p<0.001）、贫血（aOR = 2.54；95% CI 1.28,5.03；p<0.004）被发现是早产的独立危险因素。分析胎儿结局时，早产婴儿的平均出生体重为2±0.6千克，足月儿为3.1千克。
早期发现并适当治疗贫血、妊娠高血压、尿路感染和全身性疾病等各种情况有助于降低早产的发生率。
