Department of Gynaecology and Perinatology, General Hospital Trbovlje, Trbovlje, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Med Sci Monit. 2023 Feb 6;29:e938941. doi: 10.12659/MSM.938941.
BACKGROUND This retrospective population-based study analyzed data from the Slovenian National Perinatal Information System (NPIS) between 2013 and 2018 to compare neonatal morbidity and mortality following spontaneous and medically indicated preterm births. MATERIAL AND METHODS Retrospective population-based cohort. Entries to the NPIS database were searched by gestational age (GA) <37 weeks in Slovenia between 2013 and 2018. Of 9200 (6252 following spontaneous birth, 2948 following medically indicated) neonates included, 1358 were born at extremely to very preterm GA (998 following spontaneous birth, 360 following medically indicated). Logistic regression analysis was used to examine the association between neonatal mortality and composite severe neonatal morbidity and preterm birth type (spontaneous vs medically indicated) controlling for potential confounding variables. Analysis was first performed for all preterm births (GA 22 0/7 to 36 6/7) and later only for extremely to very preterm births (GA 22 0/7 to 31 6/7). RESULTS Neonatal mortality was significantly lower following spontaneous preterm birth at extremely to very preterm GA (odds ratio [OR] 0.34; 95% confidence interval [CI] [0.14, 0.81]), while there was no association in all preterm births group (OR 0.56; 95% CI [0.26, 1.20]). No significant correlation between preterm birth type and neonatal morbidity was found (OR 0.76; 95% CI [0.54, 1.09] for all preterm births and OR 0.71; 95% CI [0.47, 1.07] for extremely to very preterm births). CONCLUSIONS In this population study from Slovenia between 2013 and 2018, medically indicated preterm births at <32 weeks of GA were associated with significantly increased neonatal mortality but not neonatal morbidity.
本回顾性基于人群的研究分析了 2013 年至 2018 年期间斯洛文尼亚国家围产期信息系统（NPIS）的数据，比较了自发性和医学指征性早产的新生儿发病率和死亡率。
回顾性基于人群的队列研究。在 2013 年至 2018 年期间，斯洛文尼亚 NPIS 数据库中搜索了胎龄（GA）<37 周的记录。9200 例新生儿中，1358 例出生于极早产儿至极早产儿 GA（998 例自发性分娩，360 例医学指征性分娩）。使用逻辑回归分析，在控制潜在混杂变量的情况下，研究了新生儿死亡率与复合严重新生儿发病率以及早产类型（自发性与医学指征性）之间的关联。首先对所有早产（GA 22 0/7 至 36 6/7）进行分析，然后仅对极早产儿至极早产儿（GA 22 0/7 至 31 6/7）进行分析。
极早产儿至极早产儿 GA 的自发性早产新生儿死亡率显著降低（比值比[OR]0.34；95%置信区间[CI] [0.14, 0.81]），而在所有早产组中无关联（OR 0.56；95% CI [0.26, 1.20]）。在所有早产组中，早产类型与新生儿发病率之间无显著相关性（OR 0.76；95% CI [0.54, 1.09]），而在极早产儿至极早产儿中，两者之间无显著相关性（OR 0.71；95% CI [0.47, 1.07]）。
在 2013 年至 2018 年期间的这项斯洛文尼亚人群研究中，GA<32 周的医学指征性早产与新生儿死亡率显著增加相关，但与新生儿发病率无关。
