The Clinical Study Of Risk Factors Related With Preterm Delivery

Preterm delivery is not only one of the important causes of newborn deaths, butclosely related with various chronic diseases in adulthood. The premature infantshave many complications and the very low survival rate. Each organ is not welldeveloped. So their adverse pregnancy outcomes are closely related with birth weightand gestational age. The short term adverse pregnancy outcomes include neonataldyspnea, neonatal necrotizing enterocolitis, neonatal intraventricular hemorrhage,hypoglycemia, low birth weight, wet lung of newborn, infection, etc. The long termcomplications cover different types and degrees of cerebral palsy, sight and hearingdysfunction, mental and neuro-develepmental diseases and chronic desease tendency,especially for the premature infants with birth weight less than800grams. Pretermdelivery is not only a medical problem, but a social and economic problem. Thetreatment of premature birth becomes increasingly serious in the world, especially inthe developing countries, preterm delivery (in addition to dysplasia) is the first causeof newborn diseases and deaths. For the infants with lower gestational age, theexpensive rescue costs in NICU and unestimated long-term complications bring theever-increasing burden and pressure to the families, society. Therefore, it ismeaningful to study the causes, risk factors and gestational weeks and delivery way that lead to preterm delivery. The pregnancy care helps to know pregnancycomplications and take measures to reduce the incidence rate of preterm delivery andimprove newborn quality.The preterm delivery is crrealted to infection, too. As a sensitive index tomonitor infection, CRP is widely used in clinic, helps clinicians choose the optimalchance and way to end pregnancy and improves the prognosis of mother and infants.ObjectivesExplore the causes and risk factors of preterm delivery by retrospective casestudy. Discuss the relationship of CRP and preterm delivery and give theroticalevidence for early clinical intervention.Material and Methods1Material and Grouping(1)478cases, who were diagnosed preterm delivery in Jiaozuo Maternal andChild Health-Care Hospital from Sep2012to Sep2013, were chosen as the treatmentgroup and478cases who delivered maturely at the same time interval were controlgroup. The preterm delivery cases were divided into Spontaneous preterm birth (SPB)group (n=257) and Iatrogenic preterm birth (IPB) group (n=221) according to the causesof preterm delivery.(2)335threatened premature labors from our hospital from Sep2012to Sep2013were selected as treatment group and257term births were the control group.The treatment group was further divided into spuc failure group (n=257) and spucsuccess group (n=78).2Diagnostic Criteria：All disease names are referred to Obstetrics and Gynecology (7th edition)written by Le J. and Premature Delivery and Premature Infants written by Zeng W.3Methods(1) The clinical data, including age, number of antenatal examination, number of historical delivery, number of abortion, PPROM, HDCP, etc, from the premature andcontrol group was analyzed respectively.(2) Analyzed the distribution of gestational weeks and newborn births betweenSPB and IPB group retrospectively.(3) Compared the CRP between threatened premature labor and control group. Itis also analysed between spuc failure and spuc success group.4Statistical AnalysisThe statistical analysis was preformed by using SPSS11.5. The continuous datais summarized as X±S and compared by empoying t test. The qualitative data issummarized as proportiona and compared by using2test. All the risk factors wereanalyzed by using univarite analysia and multiple logistic regressions. The significallevel is considered to be0.05.Results1The General Clinical Data Analysis between Preterm Delivery and Control GroupThere is no significant difference on age between preterm delivery and controlgroups (P>0.05). The number of delivery, the number of abortion and the number ofantenatal examination have the significant differences between the two groups (P＜0.01).2The Univariata Analysis of Risk Factors between Preterm Delivery and Control GroupPROM, HDCP, antenatal hemorrhage and multiple pregnancies are high riskfactors of preterm delivery. They have significant differences between pretermdelivery and control groups (P＜0.05). But GDM and oligohydramnion have nosignificant difference between the two groups (P>0.05).3Multiple logistic regressionThe logistic regression model, which includes the risk factors as indepedentvarliables and preterm delivery status as depedent variables, is built and analyzed.Antenatal hemorrhage, polyhydramnios and multiple pregnancies are the major riskfactors of preterm delivery.(OR=5.32，95%CI:3.04～7.66，P﹤0.05；OR=4.21，95%CI:3.05～5.31，P﹤0.05；OR=3.02，95%CI:2.55～3.57，P﹤0.05). 4The Analysis of Delivery Ways and Newborn Births between Preterm Delivery andControl Group285(59.6%) subjects took cesarean delivery in the preterm delivery group and260(54.4%) subjects in the control group. They have no significant difference(P>0.05). In the preterm delivery group,388(75.2%) subjects had low-weight births,64(12.4%) had asphyxia neonatorum and20(3.9%) subjects had newborn deaths.And there are respectively20(4.1%),18(3.7%) and0subjects in the control group.They have significant difference (P＜0.05).5The Analysis of Gestational Weeks between SPB and IPB GroupThe gestational week has no significant difference between SPB and IPB group(P>0.05).6The Analysis of Newborn Weight, Complication and Mortality Rate between SPB and IPBGroupThe newborn weight, complication and mortality rate have significant differencebetween SPB and IPB group (P<0.05).7The CRP Analysis between Threatened Premature Labor and Term Birth GroupThe mean of CRP is13.54±2.43mg/L in threaten premature labor group and5.23±2.14mg/L in term birth group. Thay have significant difference (P<0.01). It is22.12±3.14mg/L in spuc failure group and5.64±2.57mg/L in spuc success group.They have significant difference, too (P<0.01).Conclusions1The preterm delivery is caused by multiple factors. Antenatal hemorrhage,polyhydramnios and multiple pregnancies are the major risk factors2As a infection monitoring index, CRP is highly correlated to preterm delivery.