Risk factors for medically indicated preterm birth in a Latin American population

拉丁美洲人群中医学上表明早产的危险因素

• 批准号: 7416727
• 负责人: Claudio Gerardo Sosa
• 金额: $ 5.12万
• 依托单位: FACULTAD DE MEDICINA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7416727
• 关键词: Accounting; Address; American; Applications Grants; Birth; Birth Rate; Case Management; Case-Control Studies; Cessation of life; Clinical; Country; Data; Date of birth; Economics; Funding; Future; Goals; Health; Health Priorities; Home environment; Infant; Intervention; Investigation; Latin America; Literature; Medical; Morbidity - disease rate; Neonatal; Outcome; Ovulation; Patient currently pregnant; Patients; Perinatal; Perinatal Epidemiology; Population; Population Control; Pregnant Women; Premature Birth; Premature Rupture Fetal Membranes; Prematurity of fetus; Prevention program; Principal Investigator; Productivity; Questionnaire Designs; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; Social status; Source; Term Birth; Time; Uruguay; Woman; Work; base; birth control; case-based; cohort; day; design; experience; improved; innovation; modifiable risk; mortality; neonatal morbidity; programs; social

DESCRIPTION (provided by applicant): Preterm birth is one of the main causes of neonatal and infant morbidity and mortality worldwide. In Uruguay, preterm birth accounts for 11.8% of all births and it is associated with the majority of neonatal deaths and severe neonatal morbidity, as well as with long-term morbidity. Some studies in Latin America have shown that preterm birth rates have notoriously increased during the last years as a consequence of the increase of medically indicated preterm births as well as population risk factors changes. The main objective of this study is to determine the risk factors for preterm birth in the low social economic status (SES) population from Uruguay and to examine the risk factors for medically indicated preterm births compared to the risk factors for spontaneous preterm births and for preterm births with premature rupture of membranes (PPROM) in the same population. We hypothesize that the risk factors for medically indicated preterm birth are different from the risk factors for a spontaneous preterm birth and PPROM. The existence of such differences is to be considered supportive of the hypothesis that medically indicated preterm birth is a different entity that should be separate from the other two subtypes of preterm births when researchers are approaching the topic of prematurity. The proposed investigation is a population-based case-control study in which cases will be defined by medically indicated preterm births, spontaneous preterm births and PPROM, and the controls will involve term births. During a period of time of 40 months, approximately 1,280 preterm births (cases) and 2,560 term births (controls) will be recruited in this study. All women recruited will have a complete questionnaire designed to collect data about specific risk factors. Two controls will be selected per each case, and an innovation of this case-control study will be that one control will be randomly selected from the same day of the preterm birth's delivery (traditional control selection) and a second control will be randomly selected from the due date for the corresponding case (newly proposed control). The comparison of both types of controls will offer a great opportunity to study a methodological issue that has not been yet approached in the medical literature, regarding control selection in perinatal case-control studies. The primary aims of this study will help identify modifiable risk factors to design prevention programs and possible future strategies to potentially reduce preterm birth rates. The long-term goal of this research program is to develop intervention strategies that are based on the risk factors identified in the proposed study resulting in decreased morbidity and mortality.

描述（由申请人提供）：早产是全世界新生儿和婴儿发病和死亡的主要原因之一。在乌拉圭，早产占所有出生的 11.8%，它与大多数新生儿死亡和严重新生儿发病以及长期发病有关。拉丁美洲的一些研究表明，由于医学上早产的增加以及人口危险因素的变化，过去几年中早产率显着增加。本研究的主要目的是确定乌拉圭低社会经济地位（SES）人群早产的危险因素，并与同一人群中自发性早产和胎膜早破（PPROM）早产的危险因素相比，检查医学上指示的早产的危险因素。我们假设医学上指示的早产的危险因素不同于自发性早产和未足月胎膜早破的危险因素。这种差异的存在被认为支持了这样的假设：当研究人员研究早产这一主题时，医学上指示的早产是一个不同的实体，应该与早产的其他两种亚型分开。拟议的调查是一项基于人群的病例对照研究，其中病例将根据医学上指示的早产、自发性早产和未足月胎膜早破来定义，对照将涉及足月产。在为期 40 个月的时间内，本研究将招募约 1,280 名早产儿（病例）和 2,560 名足月产者（对照）。所有招募的女性都会有一份完整的调查问卷，旨在收集有关特定风险因素的数据。每个病例选取两个对照，本病例对照研究的创新之处在于，从早产儿分娩当天随机选取一个对照（传统对照选择），从相应病例的预产期随机选取第二个对照（新提出的对照）。两种类型对照的比较将为研究医学文献中尚未涉及的关于围产期病例对照研究中对照选择的方法学问题提供一个很好的机会。这项研究的主要目的将有助于确定可改变的风险因素，以设计预防计划和未来可能降低早产率的策略。该研究计划的长期目标是根据拟议研究中确定的风险因素制定干预策略，从而降低发病率和死亡率。