Cohort study of the incidence of spontaneous preterm birth and septic abortion referred by pathological examination in Gifu prefecture in Japan

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• 作者：Yuichiro Takahashi^a ; ^b ; ^{yuichiro@nagara-lan.hosp.go.jp} ; Shigenori Iwagaki^a ; ^b ; Mitsuaki Itoh^a ; ^c ; Hiromi Nakamura^a ; ^d ; Kazuo Kuwabara^a ; ^e ; Yuka Hiraku^a ; ^f ; Masashi Hori^a ; ^g ; Ryo Misao^a ; ^h ; Tatsuro Furui^a ; ⁱ ; Kenichiro Morishige^a ; ⁱ
• 关键词：Cohort study ; Chorioamnionitis ; Funisitis ; Pathological examination ; Spontaneous preterm birth ; Septic abortion
• 刊名：Early Human Development
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：104
• 期：Complete
• 页码：33-37
• 全文大小：313 K
• 卷排序：104

文摘

To clarify the incidence of spontaneous preterm birth (PB) and septic abortion (sab) in Gifu prefecture in Japan.Study designThis prospective, population-based cohort study was approved by our hospital's Institutional Review Board. All 36 hospitals (100%) in Gifu prefecture offering obstetrical services participated in the study. Patient enrollment criteria were: sab and PB from 22 to < 37 weeks gestation (WG), excluding for maternal and fetal indications. Pathological examinations before 36 WG and associated factors for both PB and chorioamnionitis (CAM) stage 3 were analyzed by multiple logistic regression analysis judging from minimum daily clinical information in Gifu prefecture.ResultsThe sab rate per all deliveries was 29/16871 (0.17%) at 16.9 ± 2.9 WG. The total spontaneous PB rate was 615/16871 (3.65%) at 34.5 ± 2.7 WG, with birth weight (BW) 2267 ± 557 g. There were 26 (0.15%) PBs from 22 + 0 to 27 + 6 WG (weeks + days) at 25.2 ± 1.5 WG, with BW 745 ± 199 g. Among 214 pathological examinations, CAM was detected in 80% (sab) and 63% (PB < 36 WG), respectively. Funisitis were 14% and 17% respectively. Episodes of serial genital bleeding and/or hematoma at < 12 WG were more frequent in sab and earlier PB (< 28 WG) associated with CAM stage 3 (odds 1.9, P < 0.0001). Combined factors such as bleeding and past history of CAM correlated with earlier delivery at 23.4 ± 5.9 WG (P = 0.0032).ConclusionIn Gifu prefecture, the incidence of sab was 0.17% (per all deliveries) and 3.65% of spontaneous PB. The combined risk of past CAM history and bleeding was associated with earlier delivery among total preterm birth.