Preterm birth in Sweden 1973-2001:: Rate, subgroups, and effect of changing patterns in multiple births, maternal age, and smoking
Preterm birth in Sweden 1973-2001:: Rate, subgroups, and effect of changing patterns in multiple births, maternal age, and smoking
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DOI：
10.1111/j.0001-6349.2005.00765.x
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发表时间：
2005-06-01
影响因子：
4.3
通讯作者：
Jacobsson, B
中科院分区：
文献类型：
--
作者：
Morken, NH;Källen, K;Jacobsson, B
背景。本报告的目的是评估 1973 年至 2001 年瑞典早产率的变化。此外，描述了 1991 年至 2001 年期间自发性早产和指示性早产的比例，并评估了早产亚组的危险因素。方法。设计了一项以人口为基础的登记研究，研究对象为 1973 年至 2001 年在瑞典医学出生登记处登记的所有瑞典出生情况。亚组分析仅限于 1991 年至 2001 年期间。使用末次月经和最佳估计来计算孕龄。针对各亚组的自发早产和指示性早产计算与危险因素相关的早产比值比。结果。经过 20 世纪 80 年代初的上升，早产率已从 1984 年的 6.3% 下降到 2001 年的 5.6%（P < 0.0001）。多胎早产占总出生率的比例由1973年的0.34%上升到2001年的0.71%（P<0.0001）。自然早产占55.2%，医源性早产占20.2%。怀孕早期母亲吸烟与孕龄 < 28 周和自发性早产的关联性最强 [吸烟与不吸烟的比值比 (OR)：1.55，95% 置信区间 (CI)：1.42-1.69]。孕龄 < 28 周与早产之间的关联性最强（OR 5 年增加：1.34，95% CI：1.21-1.47）。结论。自 20 世纪 80 年代中期以来，瑞典的早产率有所下降。斯堪的纳维亚低风险人群中不同早产亚型的构成似乎与早产和围产期感染发生率较高的人群相似。
Background. The objectives of this report are to evaluate changes in the preterm birth rate in Sweden 1973-2001. Furthermore, describe the proportion of spontaneous and indicated preterm births and assess risk factors for the subgroups of preterm birth during the period from 1991 to 2001.Methods. A population-based register study of all births occurring in Sweden from 1973 to 2001 registered in the Swedish Medical Birth Register was designed. The analysis of subgroups was restricted to the period 1991-2001. Gestational age was calculated using last menstrual period and best estimate. Odds ratio for preterm birth related to risk factors was calculated for the subgroups' spontaneous and indicated preterm birth.Results. After an increase in the beginning of the 1980s, the preterm birth rate has decreased from 6.3% in 1984 to 5.6% in 2001 (P < 0.0001). The proportion of multiple births born preterm of the total birth rate increased from 0.34% in 1973 to 0.71% in 2001 (P < 0.0001).Spontaneous preterm births account for 55.2% and iatrogenic preterm births for 20.2% of all preterm births. The strongest association with maternal smoking in early pregnancy was found at gestational age < 28 weeks and spontaneous preterm birth [odds ratio (OR) smoking versus no smoking: 1.55, 95% confidence intervals (CI): 1.42-1.69]. The strongest association for maternal age was found between gestational age < 28 weeks and indicated preterm birth (OR 5-year increase: 1.34, 95% CI: 1.21-1.47).Conclusions. The preterm birth rate in Sweden has decreased since the mid 1980s. The composition of different subtypes of preterm birth in a Scandinavian low-risk population seems to be similar to populations with higher incidence of preterm birth and perinatal infections.