Department of Pediatrics, Wuhan Asia General Hospital, Wuhan, Hubei, China (mainland).
Department of Pediatrics, Shanghai Pudong New Area People's Hospital, Shanghai, China (mainland).
Med Sci Monit. 2022 Apr 20;28:e935094. doi: 10.12659/MSM.935094.
BACKGROUND Premature birth is an unsolved social and public problem. We aimed to explore the independent association and interaction effect between gestational hypertension (GH) and the history of preterm birth (HPB) on the risk of preterm birth. MATERIAL AND METHODS A case-control study involving participants with complete birth data was conducted using the United States National Vital Statistics System in 2019. Logistic regression analysis of 3 models were performed with odds ratio (OR) and 95% confidence interval (CI). Relative excess risk of interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were used to evaluate the interaction between GH and HPB on the risk of preterm birth. RESULTS A total of 2 822 624 participants were examined, with 10.83% in the known preterm birth group and 89.17% in the control group. Following adjustments for covariates, the association between GH and HPB and preterm birth was significant with ORs of 2.604 (95% CI: 2.573-2.635) and 3.047 (95% CI: 2.997-3.097), respectively. Moreover, there was a significant interaction between GH and HPB on preterm birth risk, with an OR of 6.095 (95% CI: 5.847-6.352), RERI of 1.222 (95% CI: 0.965-1.479), AP of 0.201 (95% CI: 0.167-0.235), and S of 1.317 (95% CI: 1.250-1.387), especially in participants with maternal age 20 to 29, 30 to 34, ≥35 years, and single birth. CONCLUSIONS GH and HPB might be positively associated with preterm birth, and there was an additive interaction between GH and HPB on preterm birth, indicating that obstetricians should pay more attention to prevention in this population.
早产是一个尚未解决的社会和公共问题。本研究旨在探讨妊娠期高血压（GH）和早产史（HPB）与早产风险的独立关联和交互作用。
采用美国国家生命统计系统 2019 年的病例对照研究，纳入了具有完整分娩数据的参与者。使用 logistic 回归分析了 3 个模型，计算比值比（OR）和 95%置信区间（CI）。相对超额交互作用风险（RERI）、交互作用归因比例（AP）和协同指数（S）用于评估 GH 和 HPB 对早产风险的交互作用。
共纳入 2822624 名参与者，已知早产组占 10.83%，对照组占 89.17%。调整协变量后，GH 和 HPB 与早产的关联具有统计学意义，OR 分别为 2.604（95%CI：2.573-2.635）和 3.047（95%CI：2.997-3.097）。此外，GH 和 HPB 对早产风险存在显著的交互作用，OR 为 6.095（95%CI：5.847-6.352），RERI 为 1.222（95%CI：0.965-1.479），AP 为 0.201（95%CI：0.167-0.235），S 为 1.317（95%CI：1.250-1.387），尤其是在母亲年龄为 20-29、30-34、≥35 岁和单胎的参与者中。
GH 和 HPB 可能与早产呈正相关，GH 和 HPB 之间存在早产的附加交互作用，提示产科医生应在此人群中更加关注预防。
