임산부의 조산경험이 다음 분만시 조산발생에 미치는 영향

The incidence of preterm delivery in subsequent pregnancy in relation to the number of previous preterm delivery was analyzed in this study. 6007 women who gave birth to two or more consecutive singleton infants at Severance Hospital, Yonsei University Medical School from January, 1961 to December, 1991 were selected as study subjects. Among the women who had preterm delivery in their first pregnancy, 20.4 % repeated preterm delivery, in their second pregnancy. 24.2 % of women who had preterm delivery in their second pregnancy, repeated on their third pregnancy, and 18.2 % in their third pregnancy repeated in their fourth pregnancy. These results showed that the incidence rates of preterm delivery were 6.8, 12.1, and 5.7 times higher, respectively, compared to that of women never experienced preterm delivery. No significant differences in preterm delivery rates in subsequent pregnancy were found according to gestational age and cause of previous preterm delivery. The diagnostic accuracy of a history of preterm delivery in predicting the repetition of preterm delivery in subsequent pregnancy were analyzed and found a sensitivity of 21.8 %, specificity of 96.8 %, positive predictive value of 20.4 %, and negative predictive value of 97 %, showing high specificity with low sensitivity. However, sensitivity improved to 44.4 % in women who repeated preterm delivery in their third pregnancy after the second pregnancy.