早產兒危險因子之探討－社區性病例對照研究

Risk Factors of Prematurity-A community-based Case Control Study

潘懿真(I-Jen Pan) ； 謝功毅(Gong-Yih Hsieh) ； 陳保中(Pau-Chung Chen)

《中華公共衛生雜誌》 18卷6期 (1999/12) Pp. 460-465

https://doi.org/10.6288/CJPH1999-18-06-09

摘要

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。

關鍵字

病例對照研究 ； 早產兒 ； 危險因子

並列摘要

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.

並列關鍵字

case-control studies ； prematurity ； risk factors