摘要目的 探讨陕西省单胎活产新生儿早产发生率及母亲既往生育史与其的相关性.方法 采用分层多阶段随机抽样方法,以问卷调查方式收集2010-2013年陕西省怀孕且其结局明确的育龄妇女生育史等相关信息.结果 共调查29 608名育龄妇女及其子女,活产单胎新生儿早产发生率为2.7％.logistic回归分析显示,早产史(OR=7.99,95％CI:5.59～ 11.43)、末次妊娠年龄≥35岁(OR=2.03,95％CI:1.59～ 2.59)、出生缺陷史(OR=1.54,95％CI:1.01～2.34)是发生早产的危险因素.妊娠间隔3～4年(与妊娠间隔≤2年者比,OR=0.74,95％CI:0.58～ 0.93)、妊娠间隔5～6年(与妊娠间隔≤2年者比,OR=0.66,95％CI:0.52 ～ 0.82)、妊娠间隔＞6年(与妊娠间隔≤2年者比,OR=0.48,95％CI:0.37～ 0.61)、生产次数1次(与初产者比,OR=0.80,95％CI:0.67～0.95)、生产次数≥2次(与初产者比,OR=0.62,95％CI:0.39 ～ 0.97)是早产的保护因素.有序多分类logistic回归分析显示,影响孕周长短的主要因素是早产史、高龄妊娠(≥35岁)及妊娠间隔时间.结论 2010-2013年陕西省单胎活产新生儿早产发生率低于全国平均水平.有早产史、高龄妊娠(≥35岁)、出生缺陷史可能增加早产发生风险;妊娠间隔长、分娩次数多可能降低早产发生风险.

abstractsObjective To analyze the incidence of preterm delivery among single live neonates and the association between maternal reproductive history and preterm birth.Methods A questionnaire survey was conducted on reproductive history among women at childbearing age who were selected through multi-stage stratified random sampling method in Shaanxi,during 2010-2013.Samples would include women at childbearing age and in pregnancy or having had definite pregnancy outcomes.Results A total of 29 608 women at childbearing age with their infants,were studied.The overall incidence of premature delivery among the single live birth neonates under this study,was 2.7％ during 2010-2013.Results from the logistic regression model showed that factors as:having had history with preterm delivery (OR=7.99,95％CI:5.59-11.43),age of the mothers,older than 35 (OR=2.03,95％CI:1.59-2.59) and with history of birth defects (OR=1.54,95％CI:1.01-2.34) were at higher risks for premature delivery in neonates.Intervals on pregnancies between 3-4 years (compared with ≤2 years,OR=0.74,95％CI:0.58-0.93),between 5-6 years (compared with ≤2 years,OR=0.66,95％CI:0.52-0.82),or ＞6 years (compared with ≤2 years,OR=0.48,95％CI:0.37-0.61)together with numbers of parity as 1 (compared with primiparas,OR=0.80;95％CI:0.67-0.95),as ≥2 (compared with primiparas,OR=0.62,95％ CI:0.39-0.97) etc.were protective factors to preterm delivery.Factors as:history of preterm delivery,mothers age (older than 35 years) and intervals of pregnancy,appeared influential to the age of gestation,under the ordinal polytomous logistic regression analysis.Conclusion The incidence of preterm births among single live birth neonates in Shaanxi was lower than the average national level.Programs related to health care services prior to conception and during pregnancy,together with increasing the self-care consciousness of childbearing aged women etc,should all be strengthened in order to reduce the occurrence of preterm birth,in Shaanxi province.