بررسی عوامل مؤثر در زایمان زودرس

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

2 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

3 استادیار گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

4 کارشناس ارشد آمار زیستی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران. دانشجوی دکترای تخصصی آموزش پزشکی، مرکز مطالعات و توسعه آموزش، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

10.22038/ijogi.2025.81229.6141

چکیده

مقدمه: زایمان زودرس، یکی از شایع‌ترین علل مرگ‌ومیر نوزادان است. نوزادان نارس در معرض اختلالات عصبی، بینایی، شنوایی و ... می­باشند. با توجه به اینکه درمان ویژه‌ای جهت توقف فرآیند زایمان زودرس وجود ندارد، مطالعه حاضر با هدف تعیین عوامل مؤثر بر زایمان زودرس در شهر سبزوار انجام شد.
روش‌کار: این مطالعه مورد- شاهدی در سال 1398 بر روی 323 زن با زایمان زودرس به‌عنوان گروه مورد و 300 زن با زایمان ترم به‌عنوان گروه شاهد در بیمارستان شهیدان مبینی سبزوار انجام شد. داده‌های مربوط به اطلاعات مادران با استفاده از چک‌لیست گردآوری شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 24) و آزمون‌‌های من‌ویتنی، کای اسکوئر و رگرسیون لجستیک انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: بین زایمان زودرس و سن مادر، میانگین تعداد مراقبت، وزن مادر، ازدواج فامیلی، درآمد پایین، سابقه پزشکی، سابقه خانوادگی، عفونت دهان و دندان، روش ­های کمک باروری، سابقه نازایی، سابقه سقط، سابقه مرده‌زایی، سابقه زایمان زودرس، تهدید به سقط، خونریزی واژن، سابقه سزارین و طول ایستادن ارتباط آماری مستقیم و معنی‌داری وجود داشت. بین میزان فعالیت، وزن‌گیری مادر، قد مادر و زایمان زودرس ارتباط آماری معکوسی وجود داشت (05/0>p). بر اساس نتایج رگرسیون لجستیک چندگانه، متغیرهای سابقه نازایی (نسبت شانس= 009/7 با فاصله اطمینان 73/2 و 994/17)، سابقه زایمان زودرس (نسبت شانس=726/4 با فاصله اطمینان 212/2 و 098/10) و تهدید به سقط (نسبت شانس= 355/11 با فاصله اطمینان 125/5 و 158/25) از متغیرهای پیشگویی کننده زایمان زودرس بودند.
نتیجه ­گیری: سن مادر، سابقه زایمان زودرس در بستگان درجه اول، ازدواج فامیلی زوجین، سابقه بیماری زمینه‌ای در مادر، سابقه عفونت دهان و دندان در مادر و سابقه مامایی مادر، تأثیر معنی‌داری در زایمان زودرس نشان داد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effective Factors of Preterm Labor

نویسندگان [English]

  • Fatemeh Roodsarabi 1
  • Jila Agah 2
  • Mahbobeh Neamatshahi 3
  • Elham Navipour 4
  • Ali Manzuri 1
1 Medical Student, Factulty of Medicine, Sabzevar University of Medical Sciences, Sabzever, Iran.
2 Associate Professor, Department of Obstetrics & Gynecology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
3 Assistant Professor, Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
4 M.Sc. in Biostatistics, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. PhD Candidate of Medical Education, Department of Medical Education, Clinical Education Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
چکیده [English]

Introduction: Preterm labor is one of the most common causes of infant death. Premature babies are also exposed to neurological, vision, hearing, etc. disorders. Considering that there is no special treatment to stop the process of preterm labor, the present study was conducted with aim to determine the effective factors of preterm labor in Sabzevar city.
Methods: This case-control study was conducted in 2019 on 323 women with preterm labor as the case group and 300 women with term labor as the control group at Shahidan Mobini Hospital in Sabzevar. Data related to maternal information were collected using a checklist. Data analysis was performed using SPSS statistical software (version 24) and Mann-Whitney, Chi-square, and logistic regression tests. P<0.05was considered significant.
Results: There was a direct and significant statistical relationship between preterm labor and maternal age, average number of visits, maternal weight, consanguineous marriage, low income, medical history, family history, oral and dental infection, assisted reproductive methods, history of infertility, history of abortion, history of stillbirth, history of preterm labor, threatened abortion, vaginal bleeding, history of cesarean section, and length of standing. There was an inverse statistical relationship between activity level, maternal weight gain, maternal height, and preterm delivery (p<0.05). Based on the results of multiple logistic regression, the variables of history of infertility (odds ratio=7.009 with a confidence interval of 2.73 and 17.994), history of preterm delivery (odds ratio=4.726 with a confidence interval of 2.212 and 10.098), and threatened miscarriage (odds ratio=11.355 with a confidence interval of 5.125 and 25.158) were predictors of preterm delivery.
Conclusion: Maternal age, history of preterm delivery in first-degree relatives, consanguineous marriage of couples, history of underlying disease in the mother, history of oral and dental infection in the mother, and history of obstetrics in the mother showed a significant effect on preterm delivery.

کلیدواژه‌ها [English]

  • Preterm Labor
  • Risk Factor
  • Term Delivery

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 5
مرداد 1404
صفحه 38-48

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