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目的探讨太原市早产流行病学及环境危险因素,为有效预防早产的发生、制定相应干预措施及卫生决策提供科学依据。方法数据来源为2009年1月至2010年12月太原市出生监测数据,监测系统共报告出生个案56 628例,满足分析要求的出生个案为50 871例,占总数的89.83%,其中早产病例数为2 163例,对照组病例数为48 708例,应用Logistic回归模型估计危险因素暴露比数比(OR)。结果多元Logistic回归模型分析结果表明,产前检查每增加一次,早产危险性降低22%;依据调整后的OR值分析结果表明,产检医院等级(OR=2.46,省级医院与县级医院相比)、母亲患有慢性疾病(OR=2.28,与无慢性疾病母亲相比)、初检孕周≤3次(OR=2.18,与初检孕周>3次相比)、和母亲职业(OR=2.00,医务人员与农民相比)对早产影响较大。其他具有统计学意义的影响因素还包括母亲居住地、母亲年龄、母亲文化程度、家庭收入、新生儿性别和妊次(这些因素的OR值范围为1.06~1.46)。本次研究初步探讨了燃煤取暖对早产的影响,结果表明:与集中供暖相比,燃煤取暖导致早产危险度升高25%(95%CI:1.11~1.42)。结论产前检查可以降低早产发生的危险性,而产科干预(辅助生产和重症监护)增加了早产儿的生存概率,由此导致早产率升高。
Objective To explore the epidemiology and environmental risk factors of preterm labor in Taiyuan and provide scientific basis for effective prevention of preterm birth, formulating appropriate interventions and health decision-making. The data of the method was from January 2009 to December 2010 in Taiyuan city birth monitoring data, the monitoring system reported a total of 56 628 cases of birth, 50 871 cases of birth to meet the analysis requirements, accounting for 89.83% of the total, of which the number of cases of preterm birth The number of cases in the control group was 48 708, and Logistic regression model was used to estimate the odds ratio (OR) of risk factors. Results The multivariate Logistic regression analysis showed that the risk of preterm birth was reduced by 22% for each additional prenatal examination. Based on the adjusted OR analysis, the hospital grade (OR = 2.46, compared with county-level hospitals ), Mothers with chronic disease (OR = 2.28, compared with mothers without chronic disease), gestational age ≤3 (OR = 2.18, compared with the first trimester) = 2.00, medical staff compared with farmers) have a greater impact on preterm birth. Other statistically significant influencing factors include mother’s place of residence, mother’s age, mother’s education, family income, neonatal sex and pregnancy (these ORs range from 1.06 to 1.46). The study initially explored the effect of coal-fired heating on preterm labor. The results showed that coal-fired heating increased the risk of preterm birth by 25% (95% CI: 1.11-1.42) compared to central heating. Conclusion Prenatal care can reduce the risk of preterm delivery, and obstetric interventions (assisted and intensive care) increase the probability of survival in preterm infants, leading to an increase in preterm delivery.