Young maternal age and preterm labor
Young maternal age and preterm labor
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DOI：
10.1016/s1047-2797(97)00046-x
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发表时间：
1997-08-01
影响因子：
5.6
通讯作者：
Krueger, PM
中科院分区：
文献类型：
--
作者：
Hediger, ML;Scholl, TO;Krueger, PM
目得：年轻，生物不成熟（以低妇科年龄为指标），以及早产的原因在Camden研究的605名孕妇中调查了特发性早产[PTL]、胎膜早破[FROM]和医学指征。样本包括366名末次月经（LMP）时< 16岁的青少年和239名LMP时18-29岁的老年妇女（对照组）。年轻的青少年明显更矮，更瘦，初潮年龄更小，超过三分之一（36.3%）的女性年龄较低，即，结果：调整种族、吸烟/天、体重增加率、身高、胎儿性别、妊娠期糖尿病和妊娠高血压综合征后，青少年PTL的风险增加了近75（校正比值比[AOR] = 1.74，95%置信区间[95% CI]：1.07-2.84）和早产伴PTL（AOR = 2.08，95% CI：1.08-4.00）。在年轻孕妇中，由于其他原因（如FROM或医学指征）导致的早产风险适度降低（AOR = 0.70，95%CI：0.28-1.75）。PTL和伴PTL早产的风险增加主要归因于生物学不成熟。年轻且妇科年龄低与PTL的双重风险相关（AOR = 2.15，95% CI：1.19-3.89）和早产伴PT，（AOR = 2.64，95%CI：1.23-5.65），而与年轻和较高的妇科年龄相关的风险仅适度增加。年轻的青少年，特别是那些低妇科年龄，似乎容易TTL和早产的风险增加，通过这一途径。(C)1997年爱思唯尔科学公司
PURPOSE: The relationship among young age, biologic immaturity (as indexed by low gynecologic age), and the causes of preterm delivery (idiopathic preterm labor [PTL], premature rupture of the membranes [FROM], and medical indications) were investigated among 605 primigravidas from the Camden Study.METHODS: The sample consisted of 366 young adolescents < 16 years at the time of their last menstrual period (LMP) and 239 older women, 18-29 years at LMP (controls). The young adolescents were significantly shorter, thinner, had younger ages at menarche, and over a third (36.3%) were of low gynecologic age, i.e., their chronologic age was 2 or fewer years more than their age at menarche.RESULTS: Adjusting for ethnicity, cigarettes smoked/day, weight gain rate, height, fetal sex, gestational diabetes mellitus, and pregnancy-induced hypertension, young adolescents overall had a nearly 75% increased risk of PTL (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [95% CI]: 1.07-2.84), and preterm delivery with PTL (AOR = 2.08, 95% CI: 1.08-4.00). There was a modest decreased risk of preterm delivery among young gravidas attributable to other causes, such as FROM or medical indications (AOR = 0.70, 95% CI: 0.28-1.75). This increased risk of PTL and preterm delivery with PTL was principally attributable to biologic immaturity. Young age with low gynecologic age was associated with a twofold risk of PTL (AOR = 2.15, 95% CI: 1.19-3.89) and preterm delivery with PT,(AOR = 2.64, 95% CI: 1.23-5.65), while the risk associated with young age and higher gynecologic age was only increased moderately.CONCLUSIONS: Young adolescents, and especially those of low gynecologic age, appear prone to TTL and are at increased risk for preterm delivery through this pathway. (C) 1997 Elsevier Science Inc.