目標:早產發生率約為5-10%,其所造成的新生兌死亡佔所有新生兌死亡(嚴重胎兌畸形除外)的85%。現階段國民保健計畫目標中,希望將台灣早產兌發生率降為4%;目前已知造成早產兒的原因只有三分之一可以被確認,其他的原因依然不明。故本研究以苗栗縣頭份鎮為研究族群,使用病例對照法,調查造成早產兒發生的潛在危險因子。方法:研究對象為86年1月至87年4月的出生嬰兒,所有病例及對照個案皆由該衛生所的出生通報資料隨機抽樣選出,並使用結構性訪問式問卷進行面訪搜集資料。結果:病例組完訪153個個案,對照組121個個案。結果發現在懷孕中未滿29週,若每天經常上下樓梯的危險勝算比為2.79(95%信賴區間=13.33-5.87);母親曾感染過水痘病毒者危險勝算比為2.49(95%信賴區間=1.30-4.22);懷孕前曾使用過避孕藥者危險勝算比為5.27(95%信賴區間=1.75-15.89);另外,曾有早產經驗者為12.85(95%信賴區間=1.60-103.51),於孕前十二個月有抽菸習慣者為3.19(95%信賴區間=1.02-9.98)。結論:本研究發現文獻中未曾提及之母親曾感染過水痘、於孕前服用口服避孕藥者,為可能的危險因子,此外,母親的身體活動量亦對該地區早產兒的發生有貢獻性。
Objectives: The incidence of prematurity is about 5-10%, but it causes 85% of neonatal death (excluding serious congenital malformations). Health Plan 2000 in Taiwan states that the incidence of prematurity will be reduced to 4%. Up to now, the causes of prematurity were only established in one third, and the others are still unknown. Thus, we used a population-based case- control study to investigate the potential risk factors of prematurity in Toufen. Methods: Cases were born from January 1997 to April 1998 and controls were randomly selected from birth registration data. Each case was interviewed using a structured questionnaire. Results: There were 153 cases and 121 controls completing the questionnaire. We found several significant risk factors such as frequently up- and downstairs before 29 weeks of gestation (odds ration (OR)=2.79,95% confidence interval (CI)=1.33-5.87), maternal chicken pox history (OR=2.49; 95% CI=1.30-4.22), oral contraceptive use (OR=5.27; 95% CI=1.75-15.89), previous prematurity(OR=12.85; 95% CI= 1.60-103.51), and smoking during one year before pregnancy (OR=3.19; 95% CI=1.02-9.98). Conclusions: Previous studies have not shown a significant relation between the exposure of chickenpox or oral contraceptives and prematurity. Otherwise, we also found that maternal physical activities may have the contribution to prematurity in Toufen.
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