Gosselink C A, Ekwo E E, Woolson R F, Moawad A, Long C R
University of Chicago Pritzker School of Medicine/La Rabida Children's Hospital and Research Center, IL.
Acta Obstet Gynecol Scand. 1993 Aug;72(6):443-9. doi: 10.3109/00016349309021132.
Premature rupture of amniotic membranes (PROM) is associated with perinatal morbidity and mortality. A matched case-control study was undertaken to determine whether adequacy of prenatal care was associated with increased risk for PROM. Three study groups were defined, consisting of women delivering pre term with PROM, full term with PROM, and pre term without PROM. Cases were singly matched by race, age, and parity with women having full term deliveries without PROM. Data were collected by face-to-face structured interviews with eligible subjects and by medical records abstraction. Conditional multiple logistic regression indicated that among women with inadequate levels of prenatal care during pregnancy the risk for pre term PROM was 3.11 (CI = 1.10-8.78) and for pre term without PROM 2.18 (CI = 1.05-4.53) times higher than for their matched controls, even when adjusted for other sociodemographic, behavioral, index pregnancy, and medical history factors. We conclude that inadequate prenatal care may be a marker for less healthy behaviors, lifestyles, and environmental factors among women at increased risk for pre term delivery.
胎膜早破（PROM）与围产期发病率和死亡率相关。开展了一项配对病例对照研究，以确定产前护理的充分程度是否与胎膜早破风险增加相关。定义了三个研究组，分别为由胎膜早破的早产女性、胎膜早破的足月女性以及无胎膜早破的早产女性组成。病例与无胎膜早破的足月分娩女性按种族、年龄和产次进行单因素配对。通过对符合条件的受试者进行面对面结构化访谈并提取医疗记录来收集数据。条件多因素逻辑回归表明，在孕期产前护理水平不足的女性中，早产胎膜早破的风险是其配对对照的3.11倍（CI = 1.10 - 8.78），无胎膜早破的早产风险是其配对对照的2.18倍（CI = 1.05 - 4.53），即使在对其他社会人口学、行为、索引妊娠和病史因素进行调整后也是如此。我们得出结论，产前护理不足可能是早产风险增加的女性中不健康行为、生活方式和环境因素的一个标志。
