Van Gils Annabelle L, Ravelli Anita C, Kamphuis Esmé I, Kazemier Brenda M, Pajkrt Eva, Oudijk Martijn A, De Boer Marjon A
Amsterdam UMC, location University of Amsterdam, Department. of Obstetrics and Gynecology, Meibergdreef 9, Amsterdam, Noord-Holland, the Netherlands.
Amsterdam Reproduction and Development Research Institute, Amsterdam, Noord-Holland, the Netherlands.
Eur J Obstet Gynecol Reprod Biol X. 2024 Nov 14;24:100356. doi: 10.1016/j.eurox.2024.100356. eCollection 2024 Dec.
To assess the risk of recurrent preterm birth following spontaneous extreme preterm birth between 16 - 27 weeks.
A nationwide retrospective cohort study was conducted with data from the Perinatal Registry of the Netherlands. We included nulliparous women with a singleton pregnancy that ended in spontaneous preterm birth between 16 and 27 weeks of gestation without congenital anomalies or antenatal death between 2010-2014 and had a subsequent pregnancy in the 5 years following (2010-2019). The primary outcome of this study was recurrent preterm birth < 37 weeks.
In total, 1011 women with linked pregnancies were included. The risk of preterm birth < 37 weeks with prior spontaneous birth between 16-19, 20-23, and 24-27 weeks was respectively 19.0 %, 29.5 % and 27.6 %. The risk of subsequent preterm birth < 24 weeks was 5.8 %, 7.2 % and 4.3 %. A short interpregnancy interval of 0-3 months was associated with increased odds for recurrent preterm birth < 32 weeks (OR 2.3 95 % CI 1.4-3.7) and preterm birth < 37 weeks (OR 1.8 95 % CI 1.2-2.6).
Patients with previous spontaneous preterm birth from 16 weeks GA onwards are at high risk for recurrent preterm birth and should be regarded as such in the consideration of preventive measures to prevent recurrent adverse pregnancy outcomes.
评估孕16 - 27周自然发生的极早早产之后复发性早产的风险。
利用荷兰围产期登记处的数据进行了一项全国性回顾性队列研究。我们纳入了2010 - 2014年期间单胎妊娠、孕16至27周自然早产且无先天性异常或产前死亡的未生育女性，并在随后5年（2010 - 2019年）有后续妊娠。本研究的主要结局是复发性早产（<37周）。
总共纳入了1011例有相关妊娠的女性。孕16 - 19周、20 - 23周和24 - 27周之前自然分娩后早产（<37周）的风险分别为19.0%、29.5%和27.6%。后续早产（<24周）的风险分别为5.8%、7.2%和4.3%。妊娠间隔短（0 - 3个月）与复发性早产（<32周）（比值比2.3，95%置信区间1.4 - 3.7）和早产（<37周）（比值比1.8，95%置信区间1.2 - 2.6）的几率增加相关。
孕16周起有既往自然早产史的患者复发性早产风险高，在考虑预防复发性不良妊娠结局的预防措施时应予以重视。
