| Objective: To explore the related factors of preterm birth in different gestational weeks,and its effect on maternal and neonatal outcomes,seek to reduce the incidence of preterm birth and improve the perinatal outcomes.Methods : Data of 11142 hospital delivery cases in General Hospital of Beijing Military Region from January 2011 to December 2014,There were 930 cases of premature birth,According to the gestational week of delivery is divided into very early preterm(24 weeks ~ 27+6 weeks pregnant),early preterm(28weeks ~ 31+6 weeks pregnant),interim preterm(32weeks ~ 33+6 weeks pregnant),late preterm(34 weeks ~ 36+6 weeks pregnant).Analysis of different gestational weeks premature group incidence,pregnant women in general(age,history of abortion,assisted reproductive technology to help pregnant,cesarean section birth history,Check,etc.),factors associated with preterm birth(premature rupture of membranes,abnormal fetal position,multiple births,pregnancy period high blood sugar,pregnancy period hypertension,placenta factors,amniotic fluid factors,anemia,fetal distress,fetal growth restriction,fetal malformation,uterine malformation),mode of delivery and neonatal status(neonatal asphyxia and birth weight),the application of SPSS software for statistical analysis,P < 0.05 has significant difference.Results:?In the four years,the rate of preterm birth was 8.35%,The incidence rate of very early preterm,early preterm,interim preterm and late preterm(composition ratio)were 0.20%(2.4%),1.36%(16.3%),1.44%(17.3%),5.3%(64.0%).?Among different gestational weeks,the general situation of pregnant womenp,such as abortion history,age(age more than or equal to 35 years old),cesarean section birth history,assisted reproductive technology have no significant difference(P > 0.05),the proportion of Irregular check in early preterm,interim preterm group was significantly higher than that of late preterm births(x2 = 18.377/8.105,P < 0.01).Separate analysis the pregnant women in our hospital,The proportion of preterm delivery in different gestational weeks were 1.4%,7.4%,12.2%,79.0%.?Premature rupture of membranes is premature first risk factors.The incidence rate was 42.8%,followed by abnormal fetal position,pregnancy period high blood sugar,pregnancy period hypertension,multiple births,fetal distress,placenta factors,anemia,fetal growth restriction,amniotic fluid factors,etc;Premature rupture of membranes alse is the first risk factor of different gestational weeks premature,the incidence rate were 36.4%,53.9%,47.2%,39.0%,the incidence of premature rupture of membranes in the early preterm group was significantly higher than that of late preterm infants(x2=11.114,p<0.01);the incidence of abnormal fetal position in early preterm group was significantly higher than that in interim preterm group and late preterm group(x2=5.628/9.988,p<0.05/ P< 0.01);pregnancy period high blood sugar has high incidence rate in the very early preterm group and early preterm group,but there was no significant difference among preterm labor groups(P>0.05);The incidence of pregnancy period hypertension in interim preterm group was significantly higher than that of late preterm group(x2=9.127,p<0.01);late preterm birth incidence of multiple pregnancy was significantly higher than that of early preterm birth,mid preterm labor group(x2=8.909/9.234,p<0.01);The incidence of fetal distress in early preterm group and interim preterm group was significantly higher than that of late preterm infants(x2=5.133/9.127,p<0.05/0.01);placenta factors,fetal growth restriction and amniotic fluid factors in different gestational age groups had no significant difference(P>0.05);The anemia incidence of very early preterm,early preterm and interim preterm was significantly higher than that of late the preterm group(x2=10.370/13.396/7.202,p<0.01),in the 930 cases of preterm birth without the risk factors and the occurrence of premature make 9.9%,the proportion in the very early preterm delivery was significantly higher than that of early preterm group(x2=11.114,P < 0.01).?Our hospital in the past 4 years total cesarean section rate was 57.6%,the group of premature delivery in cesarean section rate was 67.7%.The rate of cesarean section in different gestational weeks were 36.4%,69.1%,73.3%,67.1%,and very early preterm cesarean section rate was significantly lower than that in the early,interim and late preterm group(x2=9.035/12.308/8.903,P < 0.01).?The incidence rate of Placenta Adhesion in in different gestational weeks were 18.2%,6.6%,4.3% and 4.5%.The incidence of placenta accrete in early preterm was significantly higher than that in interim and late preterm labor group(2=6.557/8.277,P<0.01);the very early stage preterm and early preterm birth of postpartum hemorrhage was significantly higher than that of the late preterm group(x2=10.081/13.357,p<0.05/p<0.01).?The premature infants total asphyxia rate of 8.8%,The rate of asphyxia in premature infants in different gestational weeks were 57.7%,26.2%,12.4%,2.2%.with the gestational age increased the rate of neonatal asphyxia was significantly reduced(x2=179.868,P < 0.01),with gestational age increased the neonatal birth weight increased significantly(H=582.696,p<0.01).?The cesarean section rate of 31+ weeks gestation reached the highest,while the rate of neonatal asphyxia was relatively low,and the severe asphyxia rate was 0.Conclusion: 1.Pay attention to the high incidence of late preterm birth in our hospital.2.premature rupture of membranes is the first risk factor among different weeks preterm.3.Anemia in the very early,interim preterm and early preterm birth accounts for a higher proportion;4.the gestational weeks more small,the rate of placenta adhesion,postpartum hemorrhage is more high;5.Very early preterm birth is mainly vaginal delivery,Early,interim and late preterm birth mainly in cesarean delivery;6.with the increase of gestational age,The neonatal asphyxia rate was significantly decreased and the weight of neonatal hemorrhage was significantly increased;7.Pay attention to the possibility of the clinical over diagnosis the of gestational 31+ weeks premature birth. |
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