Epidemiology and causes of preterm birth.
Epidemiology and causes of preterm birth.
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DOI：
10.1016/s0140-6736(08)60074-4
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发表时间：
2008-01-05
期刊：
影响因子：
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通讯作者：
Romero R
中科院分区：
文献类型：
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作者：
Goldenberg RL;Culhane JF;Iams JD;Romero R
本文是关于早产的三部分系列文章中的第一篇，早产是发达国家围产期发病和死亡的主要原因。婴儿在胎龄小于 37 周的情况下早产：(1) 胎膜完整的自然分娩，(2) 胎膜早破 (PPROM)，以及 (3) 因母亲或胎儿适应症而进行引产或剖腹产。美国的早产率约为 12-13%，许多其他发达国家的早产率约为 5-9%；然而，许多地方的早产率有所上升，主要原因是指示性早产和人工受孕多胎早产的增加。指示性早产的常见原因包括先兆子痫或子痫以及宫内生长受限。自发性早产和未足月胎膜早破（统称为自发性早产）被认为是由多种原因引起的综合征，包括感染或炎症、血管疾病和子宫过度扩张。自发性早产的危险因素包括既往早产、黑人种族、牙周病和低孕妇体重指数。宫颈长度短和宫颈阴道胎儿纤连蛋白浓度升高是自发性早产的最强预测因素。
This paper is the first in a three-part series on preterm birth, which is the leading cause of perinatal morbidity and mortality in developed countries. Infants are born preterm at less than 37 weeks' gestational age after: (1) spontaneous labour with intact membranes, (2) preterm premature rupture of the membranes (PPROM), and (3) labour induction or caesarean delivery for maternal or fetal indications. The frequency of preterm births is about 12–13% in the USA and 5–9% in many other developed countries; however, the rate of preterm birth has increased in many locations, predominantly because of increasing indicated preterm births and preterm delivery of artificially conceived multiple pregnancies. Common reasons for indicated preterm births include pre-eclampsia or eclampsia, and intrauterine growth restriction. Births that follow spontaneous preterm labour and PPROM—together called spontaneous preterm births—are regarded as a syndrome resulting from multiple causes, including infection or inflammation, vascular disease, and uterine overdistension. Risk factors for spontaneous preterm births include a previous preterm birth, black race, periodontal disease, and low maternal body-mass index. A short cervical length and a raised cervical-vaginal fetal fibronectin concentration are the strongest predictors of spontaneous preterm birth.