子宫肌电联合宫颈长度对早产预测价值的研究

doi:10.3877/cma.j.issn.2095-3259.2026.03.008

中华产科急救电子杂志 ›› 2026, Vol. 15 ›› Issue (03) : 175 -181. doi: 10.3877/cma.j.issn.2095-3259.2026.03.008

论著

子宫肌电联合宫颈长度对早产预测价值的研究

李品, 周妙婷, 赵繁星, 王乐乐, 黄倩, 郑峥, 陈运山, 张国正, 刘慧姝^†(

)

510623　广州医科大学附属妇女儿童医疗中心产科　国家临床重点专科（产科）　广州市临床重点专科（临床医学研究所）

收稿日期:2025-04-01 出版日期:2026-08-18
通信作者: 刘慧姝
基金资助:
教育部产学合作协同育人项目(2410250043); 广州市临床高新技术项目(2019GX07); 广州市卫生健康科技项目(20231A011027); 广州市科技计划项目(2023A03J0879); 广州市临床重点专科（临床医学研究所）(穗卫函【2023】1719号)

Predictive value of uterine electromyography combined with cervical length for preterm birth

Pin Li, Miaoting Zhou, Fanxing Zhao, Lele Wang, Qian Huang, Zheng Zheng, Yunshan Chen, Guozheng Zhang, Huishu Liu^†()

Department of Obstetrics, Guangzhou Women & Children′s Medical Center, Guangzhou Medical University, National Clinical Key Specialty(Obstetrics), Guangzhou Clinical Key Specialty (Clinical Medical Research Institute), Guangzhou 510623, China

Received:2025-04-01 Published:2026-08-18
Corresponding author: Huishu Liu

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引用本文：

李品, 周妙婷, 赵繁星, 王乐乐, 黄倩, 郑峥, 陈运山, 张国正, 刘慧姝. 子宫肌电联合宫颈长度对早产预测价值的研究[J/OL]. 中华产科急救电子杂志, 2026, 15(03): 175-181.

Pin Li, Miaoting Zhou, Fanxing Zhao, Lele Wang, Qian Huang, Zheng Zheng, Yunshan Chen, Guozheng Zhang, Huishu Liu. Predictive value of uterine electromyography combined with cervical length for preterm birth[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2026, 15(03): 175-181.

目的

分析初产妇先兆早产的子宫肌电特征，并评估子宫肌电联合宫颈长度对早产预测的价值。

方法

本研究为前瞻观察性队列研究，对就诊于广州医科大学附属妇女儿童医疗中心产科门、急诊的孕24~34周有先兆早产症状的初产妇进行子宫肌电测定和宫颈长度测量，并追踪观察其临床特征、宫颈长度及妊娠结局等指标，分析子宫肌电的爆发波频率、持续时间、最大功率谱峰值频率(power density spectrum，PDS)和总功率，并结合宫颈长度绘制7 d内早产预测的ROC曲线。

结果

共有209例孕妇纳入研究，根据分娩时限将患者分为三组，48 h内分娩组(20例)，3~7 d内分娩组(22例)，>7 d分娩组(167例)；48 h内分娩组子宫肌电爆发波能量参数总功率均高于3~7 d内分娩组及>7 d分娩组，MD (I-J)值分别为(－3.13，－4.47)，差异有统计学意义(P值均<0.001)；3~7 d内分娩组总功率高于>7 d分娩组，MD (I-J)值为－1.34，差异有统计学意义(P<0.001)；子宫肌电爆发波个数、持续时间、最大PDS在三组间无统计学意义(P>0.05)；总功率预测先兆早产孕妇7 d内分娩AUC为0.88，敏感度为76.0%，特异度为86.2%；宫颈长度预测先兆早产孕妇7 d内分娩AUC为0.71，敏感度为74.0%，特异度为63.0%；当联合子宫肌电爆发波总功率和宫颈长度时，其预测先兆早产孕妇7 d内分娩的AUC为0.92，预测特异性较单独预测指标有所提升，敏感度为81.0%，特异度为90.0%。

结论

子宫肌电爆发波总功率的增加可能预示早产风险增加，子宫肌电联合宫颈长度可提高先兆早产孕妇7 d内分娩预测的准确性。

关键词: 子宫肌电, 早产, 预测, 子宫宫缩, 宫颈长度测量

Objective

To analyze the uterine electromyography (EMG) characteristics of primiparous women with threatened preterm labor and to evaluate the value of uterine EMG combined with cervical length in predicting preterm birth.

Methods

This was a prospective observational cohort study. Primiparous women at 24-34 weeks of gestation with symptoms of threatened preterm labor who presented to the obstetrics clinic or emergency department of our hospital were enrolled. Uterine EMG and cervical length measurements were performed. Clinical characteristics, cervical length, pregnancy outcomes, and uterine EMG parameters including burst wave frequency (number of burst waves per 30 minutes), burst duration, maximum power density spectrum (PDS) frequency, and total power were recorded and analyzed. ROC curves for predicting delivery within 7 days were constructed using uterine EMG parameters and cervical length, alone and in combination.

Results

A total of 209 pregnant women were included. Based on the time interval from enrollment to delivery, they were divided into three groups: delivery within 48 hours (n=20), delivery within 3-7 days (n=22), and delivery after more than 7 days (n=167). The total power of uterine EMG burst waves in the within-48-hours delivery group was significantly higher than that in the 3-7 days delivery group and the >7 days delivery group, with mean differences (I-J) of -3.13 and -4.47, respectively (both P<0.001). The total power in the 3-7 days delivery group was significantly higher than that in the >7 days delivery group, with a mean difference (I-J) of -1.34 (P<0.001). There were no statistically significant differences in the number of burst waves, burst duration, or maximum PDS among the three groups (all P>0.05). The AUC of total power for predicting delivery within 7 days was 0.88, with a sensitivity of 76.0% and a specificity of 86.2%. The AUC of cervical length for predicting delivery within 7 days was 0.71, with a sensitivity of 74.0% and a specificity of 63.0%. When uterine EMG total power was combined with cervical length, the AUC for predicting delivery within 7 days increased to 0.92, with a sensitivity of 81.0% and a specificity of 90.0%.

Conclusions

An increase in uterine EMG burst wave total power may indicate an increased risk of preterm birth. The combination of uterine EMG and cervical length can improve the accuracy of predicting delivery within 7 days in women with threatened preterm labor.

Key words: Uterine electromyography, Preterm birth, Predicting, Uterine contraction, Cervical length measurement

表1 三组不同分娩时限先兆早产孕妇的临床特征比较

组别	例数	年龄[岁，M(Q₁，Q₃)]	体重指数[kg/m²，M(Q₁，Q₃)]	检测孕周[周，M(Q₁，Q₃)]	孕次[次，M(Q₁，Q₃)]	IVF-ET[例(%)]	地塞米松[例(%)]	宫缩抑制剂[例(%)]	宫颈长度[mm，M(Q₁，Q₃)]
48 h内分娩组	20	29(29，31)	25.51(23.73，26.89)	32(30，33)	2(1，4)	2(10.00)	15(75.00)	13(65.00)	15.50(8.50，18.25)^a
3~7 d分娩组	22	31(28，35)	25.20(21.68，26.61)	30(29，33)	2(1，5)	3(13.64)	20(90.91)	18(81.82)	15.50(10.25，20.75)^b
>7 d分娩组	167	31(29，35)	24.77(22.38，26.45)	31(29，33)	2(1，5)	19(11.38)	118(70.66)	97(58.08)	23.00(15.00，32.50)
统计值		H＝1.97	H＝0.80	H＝1.63	H＝3.37	χ²＝0	χ²＝4.10	χ²＝4.78	H＝17.39
P值		0.37	0.67	0.44	0.18	0.92	0.13	0.09	<0.001

表1 三组不同分娩时限先兆早产孕妇的临床特征比较

组别	例数	年龄[岁，M(Q₁，Q₃)]	体重指数[kg/m²，M(Q₁，Q₃)]	检测孕周[周，M(Q₁，Q₃)]	孕次[次，M(Q₁，Q₃)]	IVF-ET[例(%)]	地塞米松[例(%)]	宫缩抑制剂[例(%)]	宫颈长度[mm，M(Q₁，Q₃)]
48 h内分娩组	20	29(29，31)	25.51(23.73，26.89)	32(30，33)	2(1，4)	2(10.00)	15(75.00)	13(65.00)	15.50(8.50，18.25)^a
3~7 d分娩组	22	31(28，35)	25.20(21.68，26.61)	30(29，33)	2(1，5)	3(13.64)	20(90.91)	18(81.82)	15.50(10.25，20.75)^b
>7 d分娩组	167	31(29，35)	24.77(22.38，26.45)	31(29，33)	2(1，5)	19(11.38)	118(70.66)	97(58.08)	23.00(15.00，32.50)
统计值		H＝1.97	H＝0.80	H＝1.63	H＝3.37	χ²＝0	χ²＝4.10	χ²＝4.78	H＝17.39
P值		0.37	0.67	0.44	0.18	0.92	0.13	0.09	<0.001

表2 三组不同分娩时限先兆早产孕妇子宫肌电爆发波参数的比较

组别	例数	爆发波个数[个，M(Q₁, Q₃)]	持续时间[s，M(Q₁, Q₃)]	最大PDS[Hz，±s]	总功率[pV2，M(Q₁, Q₃)]
48 h内分娩组	20	3(3，4)	30.93(26.90，35.97)	0.56±0.08	7.58(6.10，9.67)^a
3~7 d分娩组	22	3(2，4)	30.75(27.69，36.56)	0.57±0.08	5.14(4.42，5.77)^b
>7 d分娩组	167	3(2，3)	31.00(27.92，34.00)	0.54±0.08	4.03(3.24，4.56)^c
统计值		H＝3.44	H＝0.39	F＝1.70	H＝63.88
P值		0.18	0.82	0.19	<0.001

表2 三组不同分娩时限先兆早产孕妇子宫肌电爆发波参数的比较

组别	例数	爆发波个数[个，M(Q₁, Q₃)]	持续时间[s，M(Q₁, Q₃)]	最大PDS[Hz，±s]	总功率[pV2，M(Q₁, Q₃)]
48 h内分娩组	20	3(3，4)	30.93(26.90，35.97)	0.56±0.08	7.58(6.10，9.67)^a
3~7 d分娩组	22	3(2，4)	30.75(27.69，36.56)	0.57±0.08	5.14(4.42，5.77)^b
>7 d分娩组	167	3(2，3)	31.00(27.92，34.00)	0.54±0.08	4.03(3.24，4.56)^c
统计值		H＝3.44	H＝0.39	F＝1.70	H＝63.88
P值		0.18	0.82	0.19	<0.001

表3 >7 d分娩组与7 d内分娩组先兆早产孕妇临床特征比较

组别	例数	年龄[岁，M(Q₁，Q₃)]	体重指数[kg/m²，M(Q₁，Q₃)]	检测孕周[周，M(Q₁，Q₃)]	孕次[次，M(Q₁，Q₃)]	IVF-ET[例(%)]	地塞米松[例(%)]	宫缩抑制剂[例(%)]	宫颈长度[mm，M(Q₁，Q₃)]
>7 d分娩组	167	31(29，35)	24.77(22.38，26.45)	31(29，33)	2(1，2)	19(11.38)	118(70.66)	97(58.08)	23.00(15.00，32.25)
7 d内分娩组	42	30(28，35)	25.39(23.28，26.68)	32(29，33)	2(1，3)	6(11.90)	35(83.33)	31(73.81)	15.00(10.00，19.75)
统计值		Z＝－1.02	Z＝－0.77	Z＝－0.37	Z＝－1.69	χ²＝0.00	χ²＝2.75	χ²＝3.50	Z＝－4.12
P值		0.31	0.44	0.71	0.09	1.00	0.10	0.06	<0.001

表3 >7 d分娩组与7 d内分娩组先兆早产孕妇临床特征比较

组别	例数	年龄[岁，M(Q₁，Q₃)]	体重指数[kg/m²，M(Q₁，Q₃)]	检测孕周[周，M(Q₁，Q₃)]	孕次[次，M(Q₁，Q₃)]	IVF-ET[例(%)]	地塞米松[例(%)]	宫缩抑制剂[例(%)]	宫颈长度[mm，M(Q₁，Q₃)]
>7 d分娩组	167	31(29，35)	24.77(22.38，26.45)	31(29，33)	2(1，2)	19(11.38)	118(70.66)	97(58.08)	23.00(15.00，32.25)
7 d内分娩组	42	30(28，35)	25.39(23.28，26.68)	32(29，33)	2(1，3)	6(11.90)	35(83.33)	31(73.81)	15.00(10.00，19.75)
统计值		Z＝－1.02	Z＝－0.77	Z＝－0.37	Z＝－1.69	χ²＝0.00	χ²＝2.75	χ²＝3.50	Z＝－4.12
P值		0.31	0.44	0.71	0.09	1.00	0.10	0.06	<0.001

表4 >7 d分娩组与7 d内分娩组先兆早产孕妇子宫肌电参数比较

组别	例数	爆发波数[个，M(Q₁, Q₃)]	持续时间[s，M(Q₁, Q₃)]	最大PDS[Hz，±s]	总功率[pV2，M(Q₁, Q₃)]
>7 d分娩组	167	3(2，3)	31.00(27.92，34.00)	0.54±0.08	4.03(3.24，4.56)
7 d内分娩组	42	3(2，4)	30.75(27.23，36.47)	0.57±0.08	5.79(5.03，7.57)
统计值		Z＝－1.76	Z＝－0.58	t＝－1.80	Z＝－7.69
P值		0.08	0.57	0.07	<0.001

表4 >7 d分娩组与7 d内分娩组先兆早产孕妇子宫肌电参数比较

组别	例数	爆发波数[个，M(Q₁, Q₃)]	持续时间[s，M(Q₁, Q₃)]	最大PDS[Hz，±s]	总功率[pV2，M(Q₁, Q₃)]
>7 d分娩组	167	3(2，3)	31.00(27.92，34.00)	0.54±0.08	4.03(3.24，4.56)
7 d内分娩组	42	3(2，4)	30.75(27.23，36.47)	0.57±0.08	5.79(5.03，7.57)
统计值		Z＝－1.76	Z＝－0.58	t＝－1.80	Z＝－7.69
P值		0.08	0.57	0.07	<0.001

表5 各预测指标对先兆早产孕妇7 d内分娩风险的二元logistic回归分析

项目	β	Z	P值	OR(95%CI)
宫颈长度(mm)	－0.08	－3.19	0.001	0.92(0.88~0.97)
总功率(pV²)	1.78	5.39	<0.001	5.92(3.10~11.31)
常量	－8.34	23.72	<0.001	0.00(0.00~0.00)

表5 各预测指标对先兆早产孕妇7 d内分娩风险的二元logistic回归分析

项目	β	Z	P值	OR(95%CI)
宫颈长度(mm)	－0.08	－3.19	0.001	0.92(0.88~0.97)
总功率(pV²)	1.78	5.39	<0.001	5.92(3.10~11.31)
常量	－8.34	23.72	<0.001	0.00(0.00~0.00)

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Predictive value of uterine electromyography combined with cervical length for preterm birth

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Predictive value of uterine electromyography combined with cervical length for preterm birth