RISK FACTORS FOR PREMATURE BIRTH. IS EVERYTHING UNAMBIGU-OUS?

Aim. Despite the fact that ischemic-cervical insufficiency (ICI) is considered to be a risk factor for preterm birth (PB), a comparative analysis of the risk factors for each complication of gestation (ICI and PB) showed considerable differences. This was the reason for conducting a study to identify the most significant risk factors for PB and ICI. Materials and Methods. A questionnaire survey of 267 pregnant women was carried out to study the anamnestic risk factors for PR and for assessment of the course and outcomes of the current pregnancy. The existence of statistically significant differences was determined using Fishers exact test, and the ranking of risk factors was performed by the value of x2 criterion, adjusted for likelihood. Results. Pregnancy ended prematurely in 14 women (5.2%). Extremely early PB made 14.3% among all PB, premature births – 21.4%, late births – 64.3%, early PB were absent. Spontaneous and induced PB occurred with the same frequency – 50% each in the PB structure. Based on the x2 calculation, a rating of the PB risk factors was made. The 1st place – history of induced PB, 2 – history of polycystic ovary syndrome; 3 – in vitro fertilization; 4 – arterial hypertension; 5 – asymptomatic bacteriuria; 6 – ICI; 7 – hypothyroidism; 8 – the premature birth of the father. Also, an assessment of the risk factors for ICI was carried out and their rating was compiled: 1 – intra-uterine interventions before the first birth; 2 – repeated intrauterine interventions; 3 – history of ICI. Conclusion. Women with endocrine disorders (thyroid disease, polycystic ovary syndrome), arterial hypertension before and during pregnancy, physical inactivity before pregnancy should be considered a high risk group for PB. Asymptomatic bacteriuria is a risk factor not only for PB, but also for ICI, in which connection its early detection and rehabilitation is advisable. In the course of our study, the necessity for cervicometry during the 1st ultrasound screening was confirmed, and dynamic cervicometry can be recommended not only for women with PB, late spontaneous miscarriages, history of ICI and ICI in the current pregnancy, but also for pregnant women with repeated intrauterine interventions and with intrauterine interventions before the first forthcoming birth, for the earlier detection of ICI and formation of a high-risk group for PR for arrangement of preventive measures.