Malloy M H, Freeman D H
Department of Pediatrics, University of Texas Medical Branch, Galveston 77555-0526, USA.
J Perinatol. 2000 Oct-Nov;20(7):414-20. doi: 10.1038/sj.jp.7200420.
To review respiratory distress syndrome (RDS) mortality since the introduction of surfactant.
Population-based historical cohort study.
United States vital statistic data were used for the years 1987 to 1995. Linked birth and infant death file data were available for the years 1987 to 1991 and for 1995. US natality and mortality files were used for the years 1992 to 1994.
Whereas overall infant mortality decreased 25% over the-9 year period from a rate of 979 deaths/100,000 live births (LB) to a rate of 736, mortality attributed to RDS decreased 56% from a rate of 84 to 37. The crude black:white relative risk for RDS-related mortality increased from 2.02 in 1987 to 2.76 in 1995. The largest and most consistent drop in RDS-related mortality occurred in the 2000 to 2499 gm birth weight and 33- to 36-week gestation groups; average annual decline = 20%. There was a change in the distribution of the underlying causes of death over the 9-year period with an increase in the proportion of mortality attributed to prematurity.
Since the advent of surfactant there has been a marked reduction in mortality attributed to RDS. Of concern is the increasing disparity between black and white RDS-related mortality.
回顾自表面活性剂应用以来呼吸窘迫综合征（RDS）的死亡率。
基于人群的历史性队列研究。
使用1987年至1995年美国生命统计数据。1987年至1991年以及1995年可获得出生与婴儿死亡档案的关联数据。1992年至1994年使用美国出生与死亡档案。
在9年期间，总体婴儿死亡率从每10万活产儿（LB）979例死亡降至736例，下降了25%；而RDS所致死亡率从每10万活产儿84例降至37例，下降了56%。RDS相关死亡率的黑人/白人粗相对风险从1987年的2.02增至1995年的2.76。RDS相关死亡率下降幅度最大且最稳定的是出生体重在2000至2499克以及孕周为33至36周的组；年平均下降率为20%。在这9年期间，死亡根本原因的分布发生了变化，早产所致死亡率的比例有所增加。
自表面活性剂问世以来，RDS所致死亡率显著降低。令人担忧的是，黑人与白人在RDS相关死亡率方面的差距日益增大。
