Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Sci Rep. 2023 Aug 8;13(1):12839. doi: 10.1038/s41598-023-38524-9.
We evaluated the association between gestational age at threatened preterm birth (TPTB) diagnosis and preterm birth (PTB) incidence using a nationwide birth cohort. Data of 94,236 women with singleton deliveries from the Japan Environment and Children's Study (enrolled between 2011 and 2014) were analysed. Participants were divided based on parity and gestational age at TPTB diagnosis (22-24, 25-27, 28-30, 31-33, and 34-36 weeks). Multivariable logistic regression models were used to calculate the odds ratios (ORs) for PTB before 37 and 34 weeks in women from all groups, using participants without TPTB as the reference. The adjusted ORs for PTB before 37 weeks were the highest in the latest gestational age group in nulliparous and multiparous women without previous PTB, while those before 34 weeks were the highest in the earliest and latest gestational age group in multiparous women without previous PTB and in the earliest gestational age group in multiparous women with previous PTB. The association between gestational age at TPTB diagnosis and PTB incidence varies based on maternal parity and PTB before 37 or 34 weeks. Further studies with detailed clinical data and a unified TPTB diagnosis protocol are necessary to clarify this association.
我们使用全国性的出生队列评估了早产（PTB）发生前的有早产风险的妊娠（TPTB）诊断时的胎龄与早产（PTB）发生率之间的关联。分析了来自日本环境与儿童研究（2011 年至 2014 年期间招募）的 94236 名单胎分娩妇女的数据。根据产次和 TPTB 诊断时的胎龄（22-24、25-27、28-30、31-33 和 34-36 周）将参与者进行分组。使用没有 TPTB 的参与者作为参考，多变量逻辑回归模型计算了所有组中 37 周和 34 周前 PTB 的优势比（OR）。在没有既往 PTB 的初产妇和经产妇中，最晚胎龄组的 37 周前 PTB 的调整 OR 最高，而在没有既往 PTB 的经产妇和既往 PTB 的经产妇中，最早和最晚胎龄组的 34 周前 PTB 的调整 OR 最高。TPTB 诊断时的胎龄与 PTB 发生率之间的关联因产妇产次和 37 周或 34 周前的 PTB 而异。需要进一步进行具有详细临床数据和统一 TPTB 诊断方案的研究来阐明这种关联。
