Preterm births in China between 2012 and 2018: an observational study of more than 9 million women

作者：Kui Deng, Juan Liang, Yi Mu, Zheng Liu, Yanping Wang, Mingrong Li, Xiaohong Li, Li Dai, Qi Li, Peiran Chen, Yanxia Xie, Jun Zhu, Hanmin Liu · 发表于：The Lancet Global Health · 年份：2021 · DOI：10.1016/s2214-109x(21)00298-9 · 被引用次数：235 · 研究领域：Preterm Birth and Chorioamnionitis、Pregnancy and preeclampsia studies、Birth, Development, and Health

BACKGROUND: Preterm birth rates have increased significantly worldwide over the past decade. Few epidemiological studies on the incidence of preterm birth and temporal trends are available in China. This study used national monitoring data from China's National Maternal Near Miss Surveillance System (NMNMSS) to estimate the rate of preterm birth and trends between 2012 and 2018 in China and to assess risk factors associated with preterm birth. METHODS: In this observational study, data were sourced from the NMNMSS between Jan 1, 2012, and Dec 31, 2018. Pregnancies with at least one livebirth, with the baby born at 28 weeks of gestation or more or 1000 g or more birthweight were included. We estimated the rates of overall preterm, very preterm (born between 28 and 31 weeks' gestation), moderate preterm (born between 32 and 33 weeks' gestation), and late preterm (born between 34 and 36 weeks' gestation) births in singleton and multiple pregnancies and assessed their trends over time. We used logistic regression analysis to examine the associations between preterm birth and sociodemographic characteristics and obstetric complications, considering the sampling strategy and clustering of births within hospitals. Interrupted time series analysis was used to assess the changes in preterm birth rates during the period of the universal two child policy intervention. FINDINGS: From Jan 1, 2012, to Dec 31, 2018, 9 645 646 women gave birth to at least one live baby, of whom 665 244 (6·1%...