School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil.
Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
Int J Gynaecol Obstet. 2022 Sep;158(3):605-612. doi: 10.1002/ijgo.14053. Epub 2021 Dec 13.
To investigate the recurrence of preterm birth (PTB) among the poorest half of the Brazilian population.
A population-based retrospective study was conducted in Brazil with the live births of multiparous women extracted from the CIDACS Birth Cohort between 2001 and 2015. We used multivariate logistic regression to estimate the odds of recurrent PTB in second and third births.
A total of 3 528 050 live births from 1 764 025 multiparous women were analyzed. The adjusted odds for the occurrence of a PTB given a previous PTB was 2.58 (95% confidence interval [CI] 2.53-2.62). Lower gestational age increased the odds of a subsequent PTB (<28 weeks: adjusted OR [aOR] 3.61, 95% CI 3.41-3.83; 28-31 weeks: aOR 3.34, 95% CI 3.19-3.49; and 32-36 weeks: aOR 2.42, 95% CI 2.38-2.47). Women who had two previous PTBs were at high risk of having a third (aOR 4.98, 95% CI 4.70-5.27). Recurrence of PTB was more likely when the inter-birth interval was less than 12 months.
In Brazil, a middle-income country, women with a previous PTB had an increased risk of a subsequent one. This association was affected by gestational age, the number of PTBs, severity of previous PTBs, and a short interval between births.
研究巴西最贫困人群中早产（PTB）的复发情况。
本研究为基于人群的回顾性研究，从 2001 年至 2015 年，在巴西的 CIDACS 出生队列中提取多胎妇女的活产儿数据进行分析。我们使用多变量逻辑回归来估计第二次和第三次分娩中复发性 PTB 的可能性。
共分析了 1764025 名多胎妇女的 3528050 例活产儿。有既往 PTB 史的妇女发生 PTB 的调整后比值比（OR）为 2.58（95%可信区间[CI]：2.53-2.62）。较低的胎龄增加了随后发生 PTB 的可能性（<28 周：调整 OR[aOR]3.61，95%CI 3.41-3.83；28-31 周：aOR3.34，95%CI 3.19-3.49；32-36 周：aOR2.42，95%CI 2.38-2.47）。有两次既往 PTB 的妇女第三次发生 PTB 的风险很高（aOR 4.98，95%CI 4.70-5.27）。两次分娩间隔小于 12 个月时，PTB 复发的可能性更大。
在巴西这样一个中等收入国家，有既往 PTB 史的妇女随后发生 PTB 的风险增加。这种关联受胎龄、PTB 次数、既往 PTB 的严重程度和分娩间隔时间的影响。
