Department of Public Health and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.
Am J Reprod Immunol. 2024 May;91(5):e13848. doi: 10.1111/aji.13848.
Systemic chronic inflammation (SCI) is a prevalent characteristic observed in various diseases originating from different tissues, while the association of SCI with preterm birth (PTB) remains uncertain. This study aimed to analyze the association between a nonspecific biomarker of SCI and PTB, while also exploring the trajectories of SCI in pregnant women at risk of PTB.
The study used data from the Electronic Medical Record System (EMRS) of a hospital in Zhejiang, China and 9226 pregnant women were included. The duration of pregnancy was categorized into four distinct periods: the first, early-second, late-second, and third trimester. Latent class trajectory modeling (LCTM) was used to identify the trajectories of SCI during pregnancy.
The elevated WBC counts in the late-second (OR = 1.14, 95% CI: 1.06-1.23) and third (OR = 1.16, 95% CI: 1.09-1.24) trimester were both positively associated with an evaluated risk of PTB. Moreover, significant dose-response relationships were observed. There were three distinct SCI trajectories found: progressing SCI (2.89%), high SCI (7.13%), and low SCI (89.98%). Pregnant women with progressive SCI had the highest risk of PTB (OR = 3.03, 95% CI: 1.47-6.25).
In conclusion, elevated SCI after 23 weeks was a risk factor for PTB in healthy women, even if the SCI indicator was within normal range. Pregnant women with progressive SCI during pregnancy had the highest risk of PTB.
系统性慢性炎症（SCI）是一种在源自不同组织的各种疾病中普遍存在的特征，而 SCI 与早产（PTB）之间的关联尚不确定。本研究旨在分析 SCI 的非特异性生物标志物与 PTB 之间的关联，同时探讨处于 PTB 风险中的孕妇的 SCI 轨迹。
该研究使用了中国浙江一家医院的电子病历系统（EMRS）的数据，纳入了 9226 名孕妇。妊娠持续时间分为四个不同时期：第一、早期第二、晚期第二和第三孕期。使用潜在类别轨迹建模（LCTM）来识别怀孕期间的 SCI 轨迹。
晚期第二（OR=1.14，95%CI：1.06-1.23）和第三（OR=1.16，95%CI：1.09-1.24）孕期白细胞计数升高均与评估的 PTB 风险呈正相关。此外，还观察到显著的剂量反应关系。发现了三种不同的 SCI 轨迹：进展性 SCI（2.89%）、高 SCI（7.13%）和低 SCI（89.98%）。进展性 SCI 的孕妇 PTB 风险最高（OR=3.03，95%CI：1.47-6.25）。
总之，23 周后升高的 SCI 是健康女性 PTB 的危险因素，即使 SCI 指标在正常范围内。怀孕期间进展性 SCI 的孕妇 PTB 风险最高。
