OBJECTIVE
Identification of pregestational and gestational risk factors for the development of premature birth in indigenous women of the Altai Territory and the Republic of Tuva of Slavic and Tuvan ethnic groups living in challenging climatic conditions of the Siberian Federal District.
MATERIAL AND METHODS
A retrospective case—control study was conducted. The study included 365 patients with a single pregnancy, who were divided into 4 groups: 1st (n=186) were Slavs with spontaneous premature birth at gestation of 28-33 weeks and 6 days, 2nd (n=62) were Tuvinians with spontaneous premature birth at gestation pregnancy is 2833 weeks and 6 days, comparison group 1 (n=77) — Slavs with urgent labor, comparison group 2 (n=40) — Tuvan women with urgent labor. Statistical data processing was carried out using Microsoft Office Excel 2013, Statistica 6.1, SPSS 22. The socio-economic situation, unhealthy habits, obstetric and gynecological anamnesis, prevalence of extragenital and gynecological diseases, and peculiarities of the course of pregnancy were assessed.
RESULTS
The patients of the examined groups were comparable in age, more than 50% of the patients were over 30 years old, the rest were at the optimal reproductive age. The highest frequency of spontaneous premature birth was found in the 2nd group — in Tuvan housewives (in the 1st group — 31.3%, in the 2nd group — 53.2%; p=0.002). The illegitimate birth rate prevailed among the Slavs of the Altai Territory (group 1 — 21.6% and comparison group 1 — 2.6%; p=0.001). Infetious diseases of the urinary tract were more common in women of the Tuvan ethnic group with premature birth (in group 1 — 19.4%, in group 2 — 40.3%; p=0.001), inflammatory diseases of the pelvic organs (in group 1 — 8.6%, in group 2 37.1% in the group; p<0.001) and cervical pathology (in group 1 — 15.1%, in group 2 — 53.2%; p<0.001). When analyzing the course of pregnancy, it was revealed that indigenous women of the Republic of Tyva with premature birth were 2 times more likely to be diagnosed with a threatening abortion (in group 1 — 22.6%, in group 2 — 48.4%; p=0.001) and 2 times more often — gestational urinary tract infections (7.5 and 30.6%, respectively; p=0.001). There was a high incidence of vaginitis and vaginosis in all groups. In Slavs, smoking, the presence of more than two artificial abortions and early reproductive losses in the anamnesis were prognostically significant risk factors for spontaneous premature birth; in Tuvinians, the presence of cervical pathology. A personal history of premature birth turned out to be a common risk factor for the development of spontaneous premature birth for patients of both groups.
CONCLUSION
Differences in risk factors for the development of premature birth in representatives of small ethnic groups compared with Slavic women were revealed. Further research is required to identify the features of the course of somatic diseases and pregnancy complications in indigenous women of ethnic groups living in challenging climatic conditions of the Siberian Federal District in order to develop methods for the prevention of premature termination of pregnancy.
