l Introduction The etiology of prematurity exhibits many heterogenous factors and circumstances before and during pregnancy. Several authors developed Systems to assess the risk of a pre-term delivery. These scoring Systems have been become necessary, because up to 30 factors have been considered to have an influence on prematurity. The purpose has been always to select high risk patients who require intensive prenatal care in order to eliminate or to compensate such risk factors. In particular the significance of one single factor is often found to be very different from another one. Thus it has been essential to characterize each factor with a certain number of risk points. On the other hand the combuia. tion of some circumstances may magnify or diminish the calculated risk, which a mere addition of points does not represent. PAPIERNIK reported 1969 [14] his coefficient for a risk of a premature delivery based on results of own studies and literature. In a recent report [15] he could show a decrease of prematurity rate (without twins) in the area of CLAMART from 10.1 % (1973) to 3.9% (1977), assumably due to efforts of recognization of pre-term risk, followed by adequate therapeutic measures. SALING published 1972 his prematurity-dysmaturity-prevention program (PDP-program) [20] which is based mainly on present and previous obstetrical characteristics; social factors are listed Curriculum vitae
In 130 pregnant women (41 without complications, 40 with prematurity, 49 with EPH-Gestosis) Serumferritin, ferrochelatase (FCH), delta-aminolaevulinic-aciddehydratase (D-ALA-D), porphobilinogendeaminase (PBG-D) as well as hematologic routine parameters were measured. Regarding serumferritin, both uncomplicated and cases with pathologic conditions revealed a significant decrease in group II (28th week of pregnancy) as compared to group I (12th to 28th week of pregnancy). Women with EPH-Gestosis showed the lowest values. Activities of hemesynthesizing enzymes did not show any significant differences, neither between the two groups nor between uncomplicated and pathologic cases. Compared to healthy, non pregnant women; in pregnant women we found a significant increase in D-ALA-D and PBG-D, but a significant decrease in FCH. Enzyme pattern in pregnancy reveals an increased synthesis of porphobilinogen and an increased conversion of porphobilinogen to porphyrin. The low activity of FCH we measured in our study could be a reason for the elevation of free protoporphyrin in the erythrocytes.
