title: An analysis of the medical indications for preterm birth in an obstetrics and gynaecology teaching hospital in Shanghai, China.
abstract: OBJECTIVE
  preterm birth is a major cause of perinatal mortality and common cause of death in children under five years old. Although the indications for preterm birth are not fully understood, the preterm birth rate is around 11% worldwide dependent on the regions. China was cited as having a high death rate of children under five years old and one of the leading causes is preterm birth. This study sought to provide some information about preterm birth in China.
  
  
  METHODS
  retrospective survey of maternal medical records.
  
  
  METHODS
  large Obstetrics and Gynaecology university teaching hospital in Shanghai, China.
  
  
  METHODS
  all women with live births from 2010 to 2012.
  
  
  METHODS
  descriptive analysis with χ(2) test.
  
  
  METHODS
  whether birth was preterm (<37 weeks gestation), reasons for preterm birth.
  
  
  RESULTS
  there were 37,443 live births and 2541 preterm births (6.8%, 95%CI 6.5% to 7.0%) in the study period. The preterm birth rate in China is low compared with the worldwide rate. Most preterm births (85.2%) occurred at 33-37 weeks of gestation, with only 0.6% occurring before 28 weeks. Medical indications (49.3%) contributed most to preterm birth, followed by premature rupture of the membranes (39.5%) and spontaneous preterm birth (11.2%). The leading primary medical indications of preterm birth were preeclampsia, fetal distress, multiple pregnancies and placental complications.
  
  
  CONCLUSIONS
  our data suggests preterm birth in China is low and medical indications are responsible for the majority of preterm birth.
authors.affiliation: Department of Obstetrics & Gynaecology, Yulin First Hospital, Second Affiliated Hospital of Yanan University, Shanxi Province, China.
authors.forename: Qinqin
authors.initials: Q
authors.lastname: Xue
authors.affiliation: The Hospital of Obstetrics & Gynaecology, Fudan University, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department of Obstetrics & Gynaecology, Yulin First Hospital, Second Affiliated Hospital of Yanan University, Shanxi Province, China.
authors.forename: Yanyun
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Obstetrics & Gynaecology, The University of Auckland, New Zealand.
authors.forename: Mancy
authors.initials: M
authors.lastname: Tong
authors.affiliation: Wuxi Maternity and Children Hospital, Nanjing Medical University, 48 Huaishu Street, Wuxi, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.affiliation: The Hospital of Obstetrics & Gynaecology, Fudan University, China; Department of Obstetrics & Gynaecology, The University of Auckland, New Zealand. Electronic address: q.chen@auckland.ac.nz.
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000628:therapy; D005865:Gestational Age; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods / Q000706:statistics & numerical data*; D010922:Placenta Diseases / Q000453:epidemiology / Q000628:therapy; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology
keywords: China; Medical indication; Preterm birth; Spontaneous preterm birth