社会人口学因素可识别出美国有高伤害死亡率风险的婴儿。

Sociodemographic factors identify US infants at high risk of injury mortality.

作者信息

Scholer S J, Hickson G B, Ray W A

机构信息

Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.

出版信息

Pediatrics. 1999 Jun;103(6 Pt 1):1183-8. doi: 10.1542/peds.103.6.1183.

DOI:10.1542/peds.103.6.1183

PMID:10353926

Abstract

OBJECTIVES

To identify sociodemographic predictors of infant injury mortality and to compare trends in injury mortality rates for high- and low-risk US infants from 1985 to 1991.

DESIGN

Historical cohort. SETTING/STUDY PARTICIPANTS: The National Center for Health Statistics linked US infants (<1 year) born from 1985 to 1991 with death certificates.

MAIN OUTCOME MEASURES

Multivariate regression was used to identify sociodemographic factors associated with injury mortality. The adjusted relative risks (RRs) of maternal age, education, marital status, number of other children, and infant birth weight were used to categorize infants into risk groups. We compared trends in injury rates for the highest and lowest risk groups.

RESULTS

There were 5963 injury deaths and 18.6 million infant years or 32.1 injury deaths per 100 000 infant years. Highest risk infants were born to mothers who were younger than 20 years compared with older than 30 years (RR, 3.25; 95% CI, 2.92-3.63), had less than a high school education compared with a college education (RR, 2.22; 95% CI, 1.95-2.53), had more than 2 other children compared with no other children (RR, 3.15; 95% CI, 2.88-3.45), were unmarried (RR, 1.67; 95% CI, 1.57-1.78), or had birth weights </=1500 g compared with >2500 g (RR, 3.36; 95% CI, 2.94-3.84). Infants in the highest risk group (21.0% of the population) had a >10-fold increased risk of injury mortality compared with the lowest risk group (18.1% of the population) and there was no evidence that this disparity was narrowing.

CONCLUSIONS

Sociodemographic predictors of infant injury mortality include maternal age, education, number of other children, marital status, and infant birth weight. Based on these factors, 1 in 5 infants in the United States can be identified at birth as having a >10-fold increased risk of injury mortality compared with infants in lowest risk group. Programs to reduce injuries in these high-risk groups are urgently needed.

摘要

目的

确定婴儿伤害死亡率的社会人口统计学预测因素，并比较1985年至1991年美国高风险和低风险婴儿的伤害死亡率趋势。

设计

历史性队列研究。地点/研究对象：国家卫生统计中心将1985年至1991年出生的美国婴儿（<1岁）与死亡证明进行了关联。

主要观察指标

采用多变量回归分析确定与伤害死亡率相关的社会人口统计学因素。根据母亲年龄、教育程度、婚姻状况、其他子女数量和婴儿出生体重的调整相对风险（RR）将婴儿分为不同风险组。我们比较了最高风险组和最低风险组的伤害率趋势。

结果

共有5963例伤害死亡，婴儿年数为1860万，每10万婴儿年有32.1例伤害死亡。与30岁以上母亲所生婴儿相比，最高风险组婴儿的母亲年龄小于20岁（RR，3.25；95%CI，2.92 - 3.63）；与受过大学教育的母亲相比，母亲受教育程度低于高中（RR，2.22；95%CI，1.95 - 2.53）；与没有其他子女的母亲相比，有超过2个其他子女（RR，3.15；95%CI，2.88 - 3.45）；未婚（RR，1.67；95%CI，1.57 - 1.78）；或出生体重≤1500g与>2500g相比（RR，3.36；95%CI，2.94 - 3.84）。最高风险组婴儿（占总体的21.0%）的伤害死亡率比最低风险组婴儿（占总体的18.1%）高10倍以上，且没有证据表明这种差距正在缩小。