شیوع عود زایمان زودرس و عوامل مرتبط با آن در شهر ایلام

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دکترای تخصصی بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

3 کارشناس مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

4 کارشناس ارشد پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

5 استادیار گروه آمار زیستی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: زایمان زودرس و عود آن، تبعات درازمدتی برای خانواده‌ها و جوامع دارد، بنابراین ارزیابی عوامل اپیدمیولوژیک و زیست محیطی برای تشخیص زنان در معرض خطر زایمان زودرس، حائز اهمیت است. مطالعه حاضر با هدف بررسی شیوع عود زایمان زودرس و عوامل مرتبط با آن انجام شد.
روش‌کار: این مطالعه مقطعی در سال 94-1393 بر روی 3763 زن باردار مراجعه‌کننده به زایشگاه شهید مصطفی خمینی (ره) شهر ایلام انجام شد. ابزار گردآوری داده‌ها پرسشنامه پژوهشگر ساخته و شامل 37 سؤال بود که اطلاعات مربوط به متغیرهای فردی، تاریخچه مامایی و طبی مادری و متغیرهای جنینی (سن حاملگی، تعداد زایمان‌های قبلی‌، وزن تولد، آپگار، مرگ پری‌ناتال، ناهنجاری مادر‌زادی، سابقه زایمان زودرس قبلی، پرزانتاسیون، اختلالات جفت، سابقه سقط، سابقه فشارخون، دیابت در بارداری، سابقه ضربه و جراحی، اختلالات ساختمانی رحم و سرویکس، پارگی زودرس کیسه آب) جمع‌آوری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 19) و آزمون‌های آماری کای اسکوئر و تی تست انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: از مجموع 350 مورد زایمان زودرس، 289 نفر (6/82%) سابقه زایمان زودرس نداشتند و 61 نفر (4/17%) دارای سابقه زایمان زودرس قبلی بودند.بیشترین عود زایمان زودرس در سنین 40-31 سالگی یافت شد. بین سن، سطح تحصیلات، پاریته، عفونت تناسلی، عفونت ادراری، سابقه جراحی، دیابت، مرگ جنین، ناهنجارهای جنینی و عود زایمان زودرس ارتباط آماری معنی‌داری مشاهده شد (05/0>p).
نتیجه‌گیری: با توجه به بالا بودن شیوع عود زایمان زودرس در زنانی که سابقه زایمان زودرس دارند، می‌توان با افزایش مراقبت‌های بالینی و یافتن عوامل مؤثر در زایمان زودرس، از عود آن پیشگیری کرد و از شیوع عود زایمان زودرس کاست.

کلیدواژه‌ها


عنوان مقاله [English]

Prevalence of Preterm Birth Recurrence and Related Factors in Ilam

نویسندگان [English]

  • Razhan Chehreh 1
  • Zoleikha Karamolahi 2
  • Azadeh Aevazi 3
  • Milad Borji 4
  • Azam Saffar 5
1 PhD in Reproductive Health, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
2 M.Sc. in Midwifery, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
3 M.Sc. in Midwifery, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
4 M.Sc. in Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
5 Assistant Professor, Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Preterm birth and its risk of recurrence have long-term consequences on families and communities. So evaluating epidemiologic and environmental factors is important to diagnose the women at risk for early delivery. The present study aimed to investigate the prevalence of preterm birth recurrence and related factors.
Methods: This cross-sectional study was conducted on a total of 3763 pregnant women referred to Shahid Mostafa Khomeini's maternity hospital in Ilam during July 2015 to July 2016. In this study, sampling was carried out in a sequential method. Data were collected using interviews and medical records of the pregnant women. The data gathering tool was a researcher-made questionnaire containing 37 questions, including demographic variables, midwifery history, and maternal medical and fetal variables (i.e., gestational age, number of previous births, birth weight, Apgar score, perinatal death, congenital malformation, previous preterm labor, placental abnormalities, , history of abortion, history of hypertension and diabetes during pregnancy, history of trauma and surgery, uterine and cervical disorder, premature rupture of the membranes). The data were analyzed using SPSS software (version 19), Chi-square test, and t-test.
Results: Out of 350 neonates, 82.6% of them had no history of preterm labor, and 17.4% of the newborns had a history of preterm birth. The most prevalent recurrence of preterm delivery was at the age of 30-40 years. There was a statistically significant difference between the age, education level, parity, genital infection, urinary tract infection, history of surgery, diabetes, fetal death, fetal malformation, and preterm birth recurrence (P<0.05).
Conclusion: Considering the high prevalence of preterm delivery in women with a history of preterm delivery, the prevention of this important complication of pregnancy can be performed by increasing clinical care and considering the causative factors.

کلیدواژه‌ها [English]

  • Preterm Birth
  • Recurrence
  • Prevalence
  1. Leal MD, Esteves-Pereira AP, Nakamura-Pereira M, Torres JA, Theme-Filha M, Domingues RM, et al. Prevalence and risk factors related to preterm birth in Brazil. Reprod Health 2016; 13(3):127.
  2. Muglia LJ, Katz M. The enigma of spontaneous preterm birth. N Engl J Med 2010; 362(6):529-35.
  3. Di Renzo GC, Giardina I, Rosati A, Clerici G, Torricelli M, Petraglia F, et al. Maternal risk factors for preterm birth: a country-based population analysis. Eur J Obstet Gynecol Reprod Biol 2011; 159(2):342-6.
  4. Tehranian N, Ranjbar M, Shobeiri F. The prevalence and risk factors for preterm delivery in Tehran, Iran. J Midwifery Reprod Health 2016; 4(2):600-4.
  5. Tellapragada C, Eshwara VK, Bhat P, Acharya S, Kamath A, Bhat S, et al. Risk factors for preterm birth and low birth weight among pregnant indian women: a hospital-based prospective study. J Prev Med Public Health 2016; 49(3):165-75.
  6. Kamali Fard M, Alizadeh R, Sehati Shafaei F, Gojazadeh M. The effect of lifestyle on the rate of preterm birth. J Ardabil Univ Med Sci 2010; 10(1):55-63.
  7. Ajami ME, Nikkhah Shahmirzadi A, Nikkhah A. Evaluate the prevalence of premature labor and its related factors in the Shahrood in 2012. J Health Breeze 2013; 2(3):43-8. (Persian).
  8. Shoja M, Shoja E, Gharaei M. Prevalence and affecting factors on preterm birth in pregnant women Referred to Bentolhoda hospital-Bojnurd. J North Khorasan Univ Med Sci 2016; 7(4):855-63. (Persian).
  9. Zhang YP, Liu XH, Gao SH, Wang JM, Gu YS, Zhang JY, et al. Risk factors for preterm birth in five Maternal and Child Health hospitals in Beijing. PloS One 2012; 7(12):e52780.
  10. Davari Tanha F, Valadan M, Kave M, Bagherzadeh S, Hassanzadeh M. Risk factors for recurrent preterm delivery in three university hospitals. Tehran Univ Med J 2008; 65(2):24-9. (Persian).
  11. Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Hadi PA. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med 2014; 12(1):47. (Persian).
  12. Kazemier BM, Buijs PE, Mignini L, Limpens J, Groot CJ, Mol BW. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review. BJOG 2014; 121(10):1197-208.
  13. Phillips C, Velji Z, Hanly C, Metcalfe A. Risk of recurrent spontaneous preterm birth: a systematic review and metaanalysis. BMJ Open 2017; 7(6):e015402.
  14. Ferguson SE, Smith GN, Salenieks ME, Windrim R, Walker MC. Preterm premature rupture of membranes: nutritional and socioeconomic factors. Obstet Gynecol 2002; 100(6):1250-6.
  15. Yang J, Baer RJ, Berghella V, Chambers C, Chung P, Coker T, et al. Recurrence of preterm birth and early term birth. Obstet Gynecol 2016; 128(2):364-72.
  16. Lotfalizadeh M, Mohammadzadeh A, Kamandi S, Bagheri S. Prevalence and risk factors of preterm labor in imam reza hospital (2002-2003). Iran J Obstet Gynecol Infertil 2005; 8(2):93-100. (Persian).
  17. Smaill F. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2001; 8:CD000490.
  18. Gupta A, Garg PR, Nigam SH. Bacterial vaginosis in pregnancy (<28 weeks) and its effect on pregnancy outcome: a study from a Western UP city. Indian J Clin Pract 2013; 23(11):740-4.
  19. Simonsen SE, Lyon JL, Stanford JB, Porucznik CA, Esplin MS, Varner MW. Risk factors for recurrent preterm birth in multiparous Utah women: a historical cohort study. BJOG 2013; 120(7):863-72.
  20. Schempf AH, Branum AM, Lukacs SL, Schoendorf KC. Maternal age and parity-associated risks of preterm birth: differences by race/ethnicity. Pediatr Prenat Epidemiol 2007; 21(1):34-43.
  21. Gyamfi-Bannerman BC. Late preterm birth: can be reduced. Am J Obstet Gynecol 2011; 204(6):459-60.
  22. Mohsenzadeh A, Saket S, Karimi A. Prevalence of preterm neonates and risk factors.Iran J Neonatol 2011; 2(2):38-42. (Persian).
  23. Mahande MJ, Daltveit AK, Obure J, Mmbaga BT, Masenga G, Manongi R, et al. Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry-based cohort study. Trop Med Int Health 2013; 18(8):962-7.
  24. Khalajinia Z, Gholamreza J. Maternal risk factors associated with preterm delivery in Qom province of Iran in 2008. Sci Res Essays 2012; 7(1):51-4.
  25. Ratzon R, Sheiner E, Shoham-Vardi I. The role of prenatal care in recurrent preterm birth. Eur J Obstet Gynecol Reprod Biol 2011; 154(1):40-4.
  26. Neshat R, Majlesi F, Rahimi A, Shariat M, Pourreza A. Investigation the relationship between preterm delivery and prevalence of anxiety, stress and depression in pregnant women of dorrod health center, Iran in 2010. Iran J Obstet Gynecol Infertil 2013; 16(67):16-24. (Persian).
  27. Morisaki N, Togoobaatar G, Vogel JP, Souza JP, Rowland Hogue CJ, Jayaratne K, et al. Risk factors for spontaneous and provider-initiated preterm delivery in high and low Human Development Index countries: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG 2014; 121(Suppl 1):101-9.
  28. Jelliffe-Pawlowski LL, Baer RJ, Blumenfeld YJ, Ryckman KK, O’Brodovich HM, Gould JB, et al. Maternal characteristics and mid-pregnancy serum biomarkers as risk factors for subtypes of preterm birth. BJOG 2015; 122(11):1484-93.
  29. Cunningham FG, Leveno KJ, Hauth JC, editors. Williams’s obstetrics. 23th Ed. New York: McGraw Hill; 2010.
  30. Domingues RM, Dias MA, Nakamura-Pereira M, Torres JA, d’Orsi E, Pereira AP, et al. Process of decision-making regarding the mode of birth in Brazil: from the initial preference of women to the final mode of birth. Cad Saude Publica 2014; 30(Suppl 1):S1-16.
  31. Evers IM, de Valk HW, Visser GH. Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands. BMJ 2004; 328(7445):915-9.
  32. LEPERCQ J, JOEL COSTE J,THEAU A, DANIELE DUBOIS-LAFORGUE D, TIMSIT J. Factors Associated With Preterm Delivery in Women With Type 1Diabetes. Diabetes Care.2004; 27(12):2824–2828.
  33. Surkan PJ. Previous preterm and small-for-gestational-age births and the subsequent risk of stillbirth. The New England journal of medicine. 2004; 350(8): 777- 85.
  34. Ananth CV, Getahun D, Peltier MR, Salihu HM, Vintzileos AM. Recurrence of spontaneous versus medically indicated preterm birth. Am J Obstet Gynecol. 2006; 195(3):643–50.