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目的了解浙江省台州地区自然流产的流行病学特征,探讨导致早期自然流产的危险因素。方法选取浙江省台州恩泽医疗中心下属四家医院及台州市立医院早期自然流产的患者340例,选择同一时期在台州恩泽医疗中心进行健康体检的非自然流产者340例作为对照组。设计统一流行病学问卷,对基本信息、个人史、不良环境暴露情况、不良生活习惯进行调查,采用单因素和多因素logistic回归分析对危险因素进行筛查。结果单因素logistic回归分析结果提示:初次性生活年龄、婚外性伴侣数、孕次、初孕年龄、产次、产孕间隔、不良环境暴露、生殖道感染、精神压力、家族史、夜间工作、职业、劳动强度、孕前被动吸烟、既往流产史与自然流产有统计学意义(P<0.05)。多因素logistic回归分析结果提示:初孕年龄≤20岁、精神压力大、婚外性伴侣数≥2、家族史、产孕间隔≤1年、孕次>3、解脲支原体感染、既往有自然流产史、夜间工作、劳动强度大、孕前被动吸烟与自然流产发生相关,OR值(95%CI)分别为2.065(2.013~2.329),11.712(4.596~29.843),2.436(2.270~2.705),2.110(2.018~2.681),2.192(2.060~2.621),10.085(2.251~45.189),21.866(2.430~196.729),2.500(1.492~4.188),16.033(9.593~26.798),2.772(1.057~2.163),8.780(2.699~28.564)。结论浙江省台州地区自然流产防治重点人群包括初孕年龄≤20岁、精神压力大、婚外性伴侣数≥2、有家族史、产孕间隔≤1年、孕次>3、解脲支原体感染、既往有自然流产史、夜间工作、劳动强度大、孕前有被动吸烟者。
Objective To understand the epidemiological characteristics of spontaneous abortion in Taizhou, Zhejiang Province and explore the risk factors leading to spontaneous abortion in early stage. Methods A total of 340 patients with early spontaneous abortion in four hospitals affiliated to Enze Medical Center of Taizhou, Zhejiang Province and Taizhou Municipal Hospital were selected as the control group, and 340 non-spontaneous abortion patients who received physical examination at the Enshi Medical Center in Taizhou during the same period were selected as the control group. A unified epidemiological questionnaire was designed to investigate the basic information, personal history, adverse environmental exposure and unhealthy habits. The univariate and multivariate logistic regression analysis was used to screen the risk factors. Results The results of univariate logistic regression analysis indicated that the age of first sex, the number of extramarital sex partners, the number of pregnancies, the age of first trimester, the number of births, the interval of pregnancy, adverse environmental exposure, genital tract infection, stress, family history, night work , Occupation, labor intensity, passive smoking before pregnancy, history of previous abortion and spontaneous abortion were statistically significant (P <0.05). Multivariate logistic regression analysis showed that the age of first trimester was ≤20 years old, mental stress, extramarital sexual partners ≥2, family history, pregnancy interval ≤ 1 year, pregnancy times> 3, Ureaplasma urealyticum infection, former natural The OR (95% CI) were 2.065 (2.013 ~ 2.329), 11.712 (4.596 ~ 29.843), 2.436 (2.270 ~ 2.705), 2.110 (2.018-2.681), 2.192 (2.060-2.621), 10.085 (2.251-45.189), 21.866 (2.430-196.729), 2.500 (1.492-4.188), 16.033 (9.593-26.798), 2.772 (1.057-2.16), 8.780 2.699 ~ 28.564). Conclusions Key population of prevention and treatment of spontaneous abortion in Taizhou area of Zhejiang province includes the first trimester age ≤20 years old, mental stress, number of extra-marital sexual partners ≥2, family history, pregnancy interval ≤ 1 year, pregnancy time> 3, Ureaplasma urealyticum infection Past history of spontaneous abortion, night work, labor intensity, passive smoking before pregnancy.