Goldenberg R L, Iams J D, Mercer B M, Meis P J, Moawad A H, Copper R L, Das A, Thom E, Johnson F, McNellis D, Miodovnik M, Van Dorsten J P, Caritis S N, Thurnau G R, Bottoms S F
University of Alabama at Birmingham, Department of Obstetrics and Gynecology 35294-7333, USA.
Am J Public Health. 1998 Feb;88(2):233-8. doi: 10.2105/ajph.88.2.233.
This study was undertaken to determine the relationship between fetal fibronectin, short cervix, bacterial vaginosis, other traditional risk factors, and spontaneous preterm birth.
From 1992 through 1994, 2929 women were screened at the gestational age 22 to 24 weeks.
The odds ratios for spontaneous preterm birth were highest for fetal fibronectin, followed by a short cervix and history of preterm birth. These factors, as well as bacterial vaginosis, were more strongly associated with early than with late spontaneous preterm birth. Bacterial vaginosis was more common--and a stronger predictor of spontaneous preterm birth--in Black women, while body mass index less than 19.8 was a stronger predictor in non-Black women. This analysis suggests a pathway leading from Black race through bacterial vaginosis and fetal fibronectin to spontaneous preterm birth. Prior preterm birth is associated with spontaneous preterm birth through a short cervix.
Fetal fibronectin and a short cervix are stronger predictors of spontaneous preterm birth than traditional risk factors. Bacterial vaginosis was found more often in Black than in non-Black women and accounted for 40% of the attributable risk for spontaneous preterm birth at less than 32 weeks.
本研究旨在确定胎儿纤连蛋白、宫颈短、细菌性阴道病、其他传统危险因素与自发性早产之间的关系。
1992年至1994年，对2929名妊娠22至24周的妇女进行了筛查。
胎儿纤连蛋白导致自发性早产的比值比最高，其次是宫颈短和早产史。这些因素以及细菌性阴道病与早期自发性早产的关联比晚期更强。细菌性阴道病在黑人女性中更常见，且是自发性早产的更强预测因素，而体重指数低于19.8在非黑人女性中是更强的预测因素。该分析提示了一条从黑人种族经细菌性阴道病和胎儿纤连蛋白到自发性早产的途径。既往早产通过宫颈短与自发性早产相关。
胎儿纤连蛋白和宫颈短比传统危险因素更能预测自发性早产。细菌性阴道病在黑人女性中比非黑人女性中更常见，占32周前自发性早产可归因风险的40%。
