risk factors for preterm birth in an international prospective cohort of nulliparous women早产的危险因素在国际前瞻性群组的未生育过的女性.pdfVIP

Risk Factors for Preterm Birth in an International Prospective Cohort of Nulliparous Women 1,2 2 3 4 5 Gustaaf Albert Dekker *, Shalem Y. Lee , Robyn A. North , Lesley M. McCowan , Nigel A. B. Simpson , Claire T. Roberts2 1 Lyell McEwin Hospital, Adelaide, South Australia, Australia, 2 Robinson Institute, University of Adelaide, Adelaide, South Australia, Australia, 3 Division of Women’s Health, Women’s Health Academic Centre, King’s College London and King’s Health Partners, London, United Kingdom, 4 Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand, 5 Academic Department of Obstetrics and Gynaecology, University of Leeds, Leeds, United Kingdom Abstract Objectives: To identify risk factors for spontaneous preterm birth (birth ,37 weeks gestation) with intact membranes (SPTB-IM) and SPTB after prelabour rupture of the membranes (SPTB-PPROM) for nulliparous pregnant women. Design: Prospective international multicentre cohort. Participants: 3234 healthy nulliparous women with a singleton pregnancy, follow up was complete in 3184 of participants (98.5%). Results: Of the 3184 women, 156 (4.9%) had their pregnancy complicated by SPTB; 96 (3.0%) and 60 (1.9%) in the SPTB-IM and SPTB-PPROM categories, respectively. Independent risk factors for SPTB-IM were shorter cervical length, abnormal uterine Doppler flow, use of marijuana pre-pregnancy, lack of overall feeling of well being, being of Caucasian ethnicity, having a mother with diabetes and/or a history of preeclampsia, and a family history of low birth weight babies. Independent risk factors for SPTB-PPROM were shorter cervical length, short sta