Khoshnood Babak, Wall Stephen, Lee Kwang-sun
Section of Neonatology, Department of Pediatrics, University of Chicago, Chicago, Illinois, USA.
Matern Child Health J. 2005 Mar;9(1):3-9. doi: 10.1007/s10995-005-2446-4.
To examine and compare the risk of low birth weight associated with delayed childbearing in four ethnic groups using nationally representative data in the United States.
We compared the risk of low (< 2.5 kg) birth weight among African Americans, Mexican Americans, Puerto Ricans, and non-Hispanic whites using birth data for the United States obtained from the National Center for Health Statistics. Comparisons were done separately for first births and births of second or higher order and in terms of odds ratios, risk differences and attributable fractions of very low (< 1.5 kg), middle low (1.5-2.5) and overall low birth weight. Statistical analysis included use of logistic regression models with likelihood ratio tests for interaction effects.
African Americans and Puerto Ricans, and to a lesser extent Mexican Americans, had higher risk differences associated with advanced maternal age. For first births, the risk differences associated with advanced maternal age (> or = 35 years) in low birth weight were 5.3% (95% CI, 4.7-6.0), 4.3% (95% CI, 1.7-6.9), and 3.7% (95% CI, 2.8-4.5) for African Americans, Puerto Ricans, and Mexican Americans, respectively, as compared with 2.6% (95% CI, 2.4-2.7) for non-Hispanic whites. On the other hand, the odds ratios associated with advanced maternal age were more similar across the four ethnic groups. Differences were greater for all ethnic groups in the case of first births as compared with births of second or higher order.
Advanced maternal age appears to be associated with for the most part similarly increased odds of low birth weight for African Americans, Mexican Americans, Puerto Ricans, and non-Hispanic whites. However, the age-related increments in the risk of low birth associated with advanced maternal age are greater for African Americans, Puerto Ricans and, to a lesser extent, Mexican Americans, as compared with non-Hispanic whites.
利用美国具有全国代表性的数据,研究并比较四个种族群体中晚育与低出生体重风险之间的关系。
我们使用从美国国家卫生统计中心获取的出生数据,比较了非裔美国人、墨西哥裔美国人、波多黎各人以及非西班牙裔白人中低出生体重(<2.5千克)的风险。分别针对初产和二胎及以上分娩情况,就极低出生体重(<1.5千克)、低出生体重(1.5 - 2.5千克)和总体低出生体重的比值比、风险差异和归因分数进行了比较。统计分析包括使用逻辑回归模型及似然比检验来分析交互作用。
非裔美国人和波多黎各人,以及程度稍轻的墨西哥裔美国人,与高龄产妇相关的风险差异更高。对于初产,非裔美国人、波多黎各人、墨西哥裔美国人中与高龄产妇(≥35岁)相关的低出生体重风险差异分别为5.3%(95%置信区间,4.7 - 6.0)、4.3%(95%置信区间,1.7 - 6.9)和3.7%(95%置信区间,2.8 - 4.5),而非西班牙裔白人的这一风险差异为2.6%(95%置信区间,2.4 - 2.7)。另一方面,四个种族群体中与高龄产妇相关的比值比更为相似。与二胎及以上分娩相比,所有种族群体在初产情况下的差异更大。
对于非裔美国人、墨西哥裔美国人、波多黎各人以及非西班牙裔白人而言,高龄产妇似乎在很大程度上与低出生体重几率的增加相似。然而,与非西班牙裔白人相比,非裔美国人、波多黎各人以及程度稍轻的墨西哥裔美国人中,与高龄产妇相关的低出生风险随年龄增长的增幅更大。