| SETTING AND AIM: The incidence of premature is from 5 percent to 15 percent. Fifteen percent of premature infants die during the neonatal days, Apart from the abnormality which can cause death, more than 75 percent of dead perinatal infants are associated with premature delivery. In recent years, more obstetrical examination and prenatal care have been improved greatly in our country, but the incidence of premature doesn't fall remarkably. Therefore, it is necessary to seek after the etiology of premature in modern life so that infant mortality can be reduced and population diathesis can be enhanced. The studies on the risk factors for preterm delivery have been performed to various degrees all over the world, but these factors varied from country to country. We conducted a case control-study in the obstetrical department of Xijing Hospital in order to explore the risk factors for premature, and these factors provide a more definable target population for better prenatal care. METHOD: One thousand and seventy one women wereinvestigated who delivered from June 2002 to December 2003 in Xijing Hospital, the Fourth Military Medical University. One hundred and eleven premature patients were selected who delivered at gestation age between 28-37 weeks, except induced abortion. One hundred and seventeen controls were produced at random in the same period and the same hospital. The control group were defined as the eligible woman who deliver after 37 weeks of gestation, excluding the woman who deliver after gestation age 42 weeks. A case-control study was adopted with group comparison. After 55 suspected factors were analyzed with Chi-square test, seventeen risk factors for premature were revealed. Then with a multiple logistic regression, we obtained the primary risk factors for premature and calculated the etiological fraction of each risk factor .The cases that were inquiried twice showed good consistency via McNumar chi-square test. RESULTS: The seventeen risk factors for premature were gotten via single factor analyses, including pregnant woman age, poor economic status, more than 3 abortions, short maternal school education, maternal anemia, pregnancy induced hypertension, maternal heart disease, negative life events, previous preterm delivery, exposed to video display terminals, exposed to toxicant during gestation, the first obstetrical examination after gestational age 12 weeks, the frequency of obstetrical examination, exposed to noises during gestation, phone with mobile telephone longer than 5 minters everyday during gestation, maternal familial hypertension, and twin pregnancy.A multiple logistic regression model found the following factors to be independently correlated with the occurrence of preterm delivery: exposed to video display terminals more than 2.5 hours everyday during gestation (OR= 5.1, 95%CI =1.7-15.4) ,exposed to toxicantduring gestation (OR= 136.7, 95%CI =9.9-1889.6) negative life events (OR=46.1, 95%CI =2.7-771.4) .pregnancy induced hypertension (OR=4.7, 95%CI=1.1- 19.2) .previous preterm delivery (OR=159.5, 95%CI =2.5-10205.8), and their etiological fraction were 7%, 28%, 8%, 29%, 11%, respectively.Thirty women selected at random from 1071 pregnancy women were surveyed by a clinical doctor. The five risk factors were compared via McNumar chi-square test and we got consistency from 97 percent to 100 percent.CONCLUSION: Taking into account all these factors, we could get conclusion that main risk factor of premature were negative life events, pregnancy induced hypertension, previous preterm delivery, exposed to toxicant during gestation, exposed to video display terminators.Seven percent of preterm delivery resulted from exposure to video display terminators during gestation; 28 percent of preterm delivery from exposure to toxicant during gestation; 8 percent from negative life events; 29 percent from pregnancy induced hypertension; and 11 percent from previous preterm delivery. In addition, the good consistency in repeated measurement showed that questi...
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