Risk Factors For Preterm Delivery And The Influence Of The Maternal-infant Outcomes

Objective:To identify the risk factors of premature delivery,in order to predict premature delivery or to screening high-risk group of pregnant women.Which to provide a basis to effectively improve the pregnancy outcome and newborn prognosis.Methods:Part 1and 2:A retrospective study was designed and the rate of preterm birth from October 2004 to October 2008 were reviewed.The main causes of iatrogenic preterm birth were calculated.Another cases who delivered at term served as a control group,To compare the incidences of relevant factors between pregant women with preterm birth and term birth.Part 3:To study the relationship between bacterial vaginosis(BV) and premature delivery,a prospective study was conducted in 268 pregnant women,the BV was checked during the second trimester and their pregnant outcome was followed.Results:Part 1and 2:1.The rate of preterm birth from 2004 to 2008 were 7.23%,7.80%,8.12%, 7.98%.Constituent ratio of preeclampsia,vaginal bleeding caused by placenta previa and placental abruption,fetal distress in uterus which resulted in iatrogenic preterm birth,their top three reasons.2.Height gestational ages and lacking regular antenatal care is related factors of premature delivery.Premature rupture of fetal membranes(PROM), Pregnant-induced hypertension(PIH),Abnormal fetal position,Placenta factors, Multiple pregnancies,Physical disease were the major causes of preterm delivery。3.Mortality rate and incidence of asphyxia in premature infant were inverse correlated with gestational age.The mortality rate was higher in gestational age＜30weeks than that＞30weeks,statistically there was a significant defference between two groups.The incidence of RDS between gestational age＜34 weeks and gestational age＞34weeks there was a significant difference (P＜0.01).4.Incidence of asphyxia and mortality rate in premature infant was significantly different between infant with birth weight＜2kg group and weight＞2kg group.Gestational age and weight of premature infants with asphyxia was markedly lower than those without asphyxia.The incidence of risk factors of preterm birth were not significantly different between the premature infants with and without asphyxia(P＞0.05).Part 3:There was a significant difference in the incidence of premature delivery between BV positive group and negative group.(P＜0.01)Conclusions:In recent years,the trend of preterm birth was rising.Premature delivery is related to many factors and it is the important factors leading perinatal morbidity and mortality.Premature rupture of fetal membranes(PROM),Pregnant-induced hypertension(PIH),Abnormal fetal position,Placenta factors,Multiple pregnancies,Physical disease were the major causes of preterm delivery.Risk factors of preterm birth should be prevent.Gestational age and neonatal weight were the main effective factors on perinatal outcome.To prolong pregnancy and increase fetal weight with the precondition of maternal and fetal safety was an effective way to improve the infant's outcome.The incidence of premature delivery in patients with BV were significantly higher than that in normal pregnant women.BV is one important reason to abortion in prevalence.BV screening in pregnant women should be routinely conducted to treat in time and to reduce the bad prognosis.