Kashani-Ligumsky Lior, Neiger Ran, Segal Ella, Cohen Ronnie, Lopian Miriam
Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
J Clin Med. 2024 Jan 12;13(2):429. doi: 10.3390/jcm13020429.
Most preterm births occur in the late preterm period. While prematurity-related adverse outcomes are significantly diminished when birth occurs during this period, these infants are still at increased risk of complications. Parity affects the incidence of obstetric complications. The purpose of this study was to determine whether parity impacts the risk of spontaneous late preterm birth (SLPTB) and associated complications. A retrospective observational cohort study was conducted. Patients were divided into three study groups according to parity. The primary outcome was the rate of SLPTB in each group. Secondary outcomes were unplanned cesarean delivery (UCD), prolonged third stage of labor respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), intraventricular hemorrhage (IVH), neonatal hypoglycemia, duration of NICU admission, neonatal death, and composite adverse neonatal outcome (CANO). Primiparas were more likely to have SLPTB, UCD, and CANO compared to multiparas (2.6% vs. 1.9% OR 1.5 [1.3-1.7] < 0.01) (4.1% vs. 1.3% OR 2.7 [1.2, 5.9] < 0.01) (8.5% vs. 4.2 OR 2.1 [1.3-3.5] = 0.002) and grandmultiparas (2.6% vs. 1.7% OR 1.4 [1.2-1.5] < 0.001) 8.5% vs. 4.4% OR 2.0 [1.1, 3.8], = 0.01) but no difference in UCD compared to grandmultiparas (4.1% vs. 3.3% OR 1.2 [0.6-2.7] = 0.28). Primiparas are at increased risk of SLPTB and UCD, and this is accompanied by an increased risk of adverse neonatal outcomes.
大多数早产发生在晚期早产阶段。虽然在此期间出生时与早产相关的不良后果会显著减少，但这些婴儿仍有更高的并发症风险。产次会影响产科并发症的发生率。本研究的目的是确定产次是否会影响自发性晚期早产（SLPTB）及相关并发症的风险。进行了一项回顾性观察队列研究。根据产次将患者分为三个研究组。主要结局是每组的SLPTB发生率。次要结局包括非计划剖宫产（UCD）、产程第三产程延长、呼吸窘迫综合征（RDS）、新生儿短暂性呼吸急促（TTN）、脑室内出血（IVH）、新生儿低血糖、新生儿重症监护病房（NICU）住院时间、新生儿死亡以及综合不良新生儿结局（CANO）。与经产妇相比，初产妇发生SLPTB、UCD和CANO的可能性更高（2.6%对1.9%，比值比[OR]为1.5[1.3 - 1.7]，<0.01）（4.1%对1.3%，OR为2.7[1.2, 5.9]，<0.01）（8.5%对4.2%，OR为2.1[1.3 - 3.5]，=0.002），与经产妇相比，初产妇发生UCD的差异无统计学意义（4.1%对3.3%，OR为1.2[0.6 - 2.7]，=0.28）。与经产妇相比，初产妇发生SLPTB和UCD的风险增加，且这伴随着不良新生儿结局风险的增加。 与多产妇相比，初产妇发生SLPTB、UCD和CANO的可能性更高（2.6%对1.7%，OR为1.4[1.2 - 1.5]，<0.001）（8.5%对4.4%，OR为2.0[1.1, 3.8]，=0.01），但与多产妇相比，UCD差异无统计学意义（4.1%对3.3%，OR为1.2[0.6 - 2.7]，=0.28）。初产妇发生SLPTB和UCD的风险增加，且这伴随着不良新生儿结局风险的增加。
