The findings of an international group of experts, to be presented at the annual conference today of the European Society of Human Reproduction and Embryology (ESHRE) in Amsterdam, Netherlands, should make it easier for doctors to predict which women may need special care and attention during pregnancy.
Premature babies can survive from as early as 22 weeks' gestation, but they are on the border of viability. Every extra week of life in the womb increases chances of survival and improves prospects of long-term health without significant disability.
Dr Robbert van Oppenraaij from the department of obstetrics and gynaecology at Erasmus University medical centre in Rotterdam, Netherlands, and colleagues from the UK, Denmark and Spain reviewed 75 studies carried out between 1980 and 2008, looking at the impact of complications in early pregnancy.
They found that women who experienced complications either early in their current pregnancy or who had had a miscarriage or other problem in a previous pregnancy were more at risk of going into labour prematurely or experiencing other difficulties in later weeks.
Women who had experienced one or more miscarriages had nearly double the risk in their next pregnancy of giving birth prematurely. Those who had suffered three or more miscarriages were at even greater risk.
Termination of a previous pregnancy, for any reason, also increased the risk of premature birth in a subsequent pregnancy.
A whole range of problems in the first three months of a pregnancy were predictive of later complications:
• Vaginal bleeding increased the risk of pre-eclampsia or dangerously high blood pressure in the woman, as well as raising the chances that the baby would be born prematurely and under-weight.
• The survivor of a vanishing twin pregnancy (where one twin miscarries very early on) was more likely to be born prematurely, had three times the normal risk of very low birth weight and was more than three times more likely to die around the time of birth.
• Women who suffered from extreme early morning sickness were three times more likely to give birth prematurely and the baby was nearly three times more likely to be of low weight.
Identifying these women as at high risk of problem births would help to ensure their babies have the best chance of survival through careful monitoring of the baby's development, said Van Oppenraaij. More studies are needed to confirm the findings, he said.
Events and complications in early pregnancy can be extremely distressing for women, Van Oppenraaij said. For the clinician it is important to interpret the symptoms and to understand not only the short-term consequences, but also the long-term consequences of these early pregnancy complications. This is especially important for reassuring and supporting the couple at a difficult time.
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医生发现，有流产经历的妇女在下一胎更容易出现早产。
在每年一次于荷兰阿姆斯特丹举行的的欧洲人类生殖和胚胎学协会会议上，国际专家小组提出了这一系列的发现，这意味着医生们能更容易判断哪些妇女在妊娠期可能需要接受特别看护。
早产婴儿虽然能在怀孕22周时存活，但是危险性极高。婴儿每留在母体子宫中多一周就多出了一分存活的可能性，也增加了没有重大残疾保持长期健康的可能性。
荷兰鹿特丹伊拉斯谟大学医学中心妇产科医生Robbert van Oppenraaij和他来自英国、丹麦和西班牙的同事一同复阅了1980到2008年间进行的研究，尝试找出早期妊娠并发症的影响。
他们发现无论是在妊娠早期经历过并发症的妇女还是曾有流产经历或在以前怀孕期间有过其他问题的妇女，她们在接下来的妊娠期中都有早产或遭遇其他困难的危险。
曾有一次或一次以上流产经历的妇女几乎有双倍的可能性在她们的下一次妊娠时早产，而那些有三次或以上流产经历的妇女则更加危险。
他们也发现孕妇前一次的终止妊娠行为也极有可能增加下一胎早产的几率。
研究表明，前三个月妊娠期中出现的一系列问题预示着接下来的并发症：
阴道出血易引起孕妇子痫或危险性高血压，也易引起早产或新生儿体重不达标。
双胞胎中幸存的那一名婴儿（另一名早前已经流产）很可能早产，也比平常婴儿多出三倍的可能性出现体重严重不达标情况或者在生产过程中死亡的现象。
有严重清晨恶心呕吐现象的孕妇有比普通孕妇多三倍的可能性早产，她们的婴儿出现体重过轻现象的可能也增加了近三倍。
Van Oppenraaij医生指出，鉴定出这些极有可能出现问题的孕妇有助于通过对她们婴儿生长的仔细监控提高婴儿的存活率。同时，他也提出他们需要做更多的研究来证实这项发现。
Van Oppenraaij医生说，对孕妇来说，一些妊娠早期的并发症和其他症状确实很难熬。但对医生来说，解释这些症状和了解这些妊娠早期的并发症带来的结果，不仅仅是短期的，还有长期的结果，也异常重要。因为，它们是那些处于困难时期的夫妇获得安抚和支撑的源泉。 |
