Impact of additional risk factors on the incidence of preterm delivery among pregnant women diagnosed with short cervix
Impact of additional risk factors on the incidence of preterm delivery among pregnant women diagnosed with short cervix
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其他危险因素对诊断为短宫颈孕妇早产发生率的影响
DOI：
10.1016/j.tjog.2020.01.005
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发表时间：
2020
影响因子：
2.1
通讯作者：
Fujii Tomoyuki
中科院分区：
文献类型：
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作者：
Samejima Taiki;Nagamatsu Takeshi;Iriyama Takayuki;Nakayama Toshio;Seyama Takahiro;Sayama Seisuke;Kumasawa Keiichi;Komatsu Atsushi;Kawana Kei;Osuga Yutaka;Fujii Tomoyuki
目的宫颈缩短孕妇早产的其他危险因素尚不完全清楚；然而，妊娠中期颈椎缩短被认为是早产的危险因素。本研究旨在确定在妊娠中期晚期检测到短子宫颈的患者中与随后早产相关的危险因素。材料和方法本研究是对一家围产期三级医院的医疗资料进行回顾性研究。我们确定了134名无症状的单胎妊娠妇女，在22-33周的常规普遍筛查中发现宫颈缩短（≤25 mm）。进行统计分析以确定早产发生率与已知早产危险因素之间的因果关系。结果早产发生率为27.6%(37/134)，早破率为46.0%（17/37）。通过logistic回归分析，我们确定子宫收缩[aOR 4.25, 95%可信区间（CI）： 1.68-12.1]和血液检查中c反应蛋白（CRP）升高和白细胞（WBC）升高（CRP: aOR 3.45, 95% CI: 1.50-9.71; WBC: aOR 1.28, 95% CI: 1.08-1.55）是显著增加短宫颈女性早产风险的危险因素。子宫收缩和c反应蛋白（CRP）均呈阳性的妇女91%发生早产。结论子宫收缩和CRP升高是短宫颈妇女早产的附加危险因素。这些结果可能对评估妊娠中期宫颈短的无症状孕妇的后续早产风险有临床价值。
ObjectiveAdditional risk factors for preterm delivery in pregnant women with cervical shortening are not fully understood; however, mid-trimester cervical shortening is accepted as a risk factor for preterm delivery. This study aimed to identify risk factors associated with subsequent preterm delivery among patients with short cervix detected after late mid-trimester.Materials and methodsThis was a retrospective study of medical data from a single perinatal tertiary facility. We identified 134 asymptomatic women with singleton pregnancies where cervical shortening (≤25 mm) was detected during routine universal screening at 22–33 weeks. Statistical analyses were conducted to identify causal relationships between the incidence of preterm delivery and known risk factors for preterm delivery.ResultsIncidence of preterm delivery was 27.6% (37/134) and preterm premature rupture of membrane was preceded in 46.0% (17/37) of the women with preterm delivery. Using logistic regression analysis, we identified uterine contractions [aOR 4.25, 95% confidence intervals (CI):1.68–12.1] and increased C-reactive protein (CRP) and increased white blood cell (WBC) in blood test (CRP: aOR 3.45, 95% CI:1.50–9.71; WBC: aOR 1.28, 95% CI: 1.08–1.55) as risk factors which significantly increased the risk of preterm delivery among women diagnosed with short cervix. Preterm delivery occurred in 91% of women positive for both uterine contractions and CRP >0.5 mg/dl.ConclusionsUterine contraction and elevated CRP were additional risk factors for preterm delivery among women with short cervix. These results might be clinically useful to evaluate subsequent risk for preterm delivery in asymptomatic pregnant women presenting with short cervix in mid-pregnancy.