产前护理数据的来源及其与感染艾滋病毒妇女分娩结局的关联。
Sources of prenatal care data and their association with birth outcomes of HIV-infected women.
作者信息
Turner B J, Cocroft J, Newschaffer C J, Hauck W W, Fanning T R, Berlin M
机构信息
Center for Research in Medical Education and Health Care, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pa., USA.
出版信息
Am J Public Health. 2000 Jan;90(1):118-21. doi: 10.2105/ajph.90.1.118.
OBJECTIVES
Different sources of prenatal care data were used to examine the association between birth outcomes of HIV-infected women and the Adequacy of Prenatal Care Utilization (APNCU) index.
METHODS
Adjusted odds ratios of birth outcomes for 1858 HIV-positive mothers were calculated for APNCU indexes on the basis of birth certificate data or 3 types of physician visits on Medicaid claims.
RESULTS
Claims- and birth certificate-based APNCU indexes agreed poorly (kappa < 0.3). Only the broadest claims-based APNCU index had lower adjusted odds ratios for low birthweight (0.64; 95% confidence interval [CI] = 0.49, 0.84) and preterm birth (0.70; 95% CI = 0.54, 0.91). The birth certificate-based index had a reduced adjusted odds ratio (0.73; 95% CI = 0.56, 0.95) only for preterm birth.
CONCLUSIONS
The association of birth outcomes and adequacy of prenatal care in this HIV-infected cohort differed significantly depending on the source of prenatal care data.
目的
使用不同来源的产前护理数据来检验感染艾滋病毒女性的分娩结局与产前护理利用充分性（APNCU）指数之间的关联。
方法
根据出生证明数据或医疗补助申请中的3种类型的医生就诊情况，计算1858名艾滋病毒呈阳性母亲分娩结局的调整比值比，以得出APNCU指数。
结果
基于申请和出生证明的APNCU指数一致性较差（kappa<0.3）。只有最宽泛的基于申请的APNCU指数在低出生体重（0.64；95%置信区间[CI]=0.49，0.84）和早产（0.70；95%CI=0.54，0.91）方面的调整比值比更低。基于出生证明的指数仅在早产方面调整比值比降低（0.73；95%CI=0.56，0.95）。
结论
在这个感染艾滋病毒的队列中，分娩结局与产前护理充分性之间的关联因产前护理数据来源的不同而有显著差异。
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