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根据产科特征预测婴儿猝死综合征风险:一项对505,011例活产儿的回顾性队列研究。

Predicting the risk for sudden infant death syndrome from obstetric characteristics: a retrospective cohort study of 505,011 live births.

作者信息

Smith Gordon C S, White Ian R

机构信息

Department of Obstetrics and Gynaecology, Cambridge University, Cambridge, United Kingdom.

出版信息

Pediatrics. 2006 Jan;117(1):60-6. doi: 10.1542/peds.2004-2828.

Abstract

OBJECTIVE

We sought to develop a simple robust method for assessing the risk for sudden infant death syndrome (SIDS) on the basis of obstetric characteristics.

METHODS

A population-based retrospective cohort study was conducted of data from the linked Scottish Morbidity Record, Stillbirth and Infant Death Enquiry and General Registrar's Office database of births and deaths, encompassing births in Scotland between 1992 and 2001. All women who had a singleton live birth between 24 and 43 weeks' gestation and for whom data were available (n = 505,011), divided into model development and validation samples, were studied. The main outcome measure was death of the infant in the first year of life as a result of SIDS.

RESULTS

The risk for SIDS was modeled in the development sample using logistic regression with the following predictors: maternal age, parity, marital status, smoking, and the birth weight and the gender of the infant. When the model was evaluated in the validation sample, the area under the receiver operating characteristic curve was 0.84 and the incidence of SIDS was 0.7 per 10,000 (95% confidence interval: 0.3-1.4) among 126,253 women in the lower 50% of predicted risk and 29.7 per 10,000 (95% confidence interval: 23.4-37.2) among the 25,250 women in the top 10% of predicted risk. A logistic-regression model then was developed for the whole population, and the output was converted into adjusted likelihood ratios. These are tabulated and provide a simple method for assessing the risk for SIDS associated with any combination of obstetric characteristics.

CONCLUSIONS

A model that uses maternal characteristics and outcome at birth is predictive of the risk for SIDS. This model is presented in a simple form that allows calculation of the individual risk for SIDS.

摘要

目的

我们试图开发一种基于产科特征评估婴儿猝死综合征(SIDS)风险的简单可靠方法。

方法

基于苏格兰发病率记录、死产和婴儿死亡调查以及总登记官办公室出生和死亡数据库的关联数据,进行了一项基于人群的回顾性队列研究,涵盖1992年至2001年在苏格兰的出生情况。对所有在妊娠24至43周之间单胎活产且有可用数据的妇女(n = 505,011)进行研究,分为模型开发和验证样本。主要结局指标是婴儿在生命第一年因SIDS死亡。

结果

在开发样本中使用逻辑回归对SIDS风险进行建模,预测变量包括:母亲年龄、产次、婚姻状况、吸烟情况以及婴儿出生体重和性别。当在验证样本中评估该模型时,接受者操作特征曲线下面积为0.84,在预测风险较低的50%的126,253名妇女中,SIDS发病率为每10,000人中有0.7例(95%置信区间:0.3 - 1.4),在预测风险最高的10%的25,250名妇女中,SIDS发病率为每10,000人中有29.7例(95%置信区间:23.4 - 37.2)。然后为整个人口开发了一个逻辑回归模型,并将输出转换为调整后的似然比。这些以表格形式列出,为评估与任何产科特征组合相关的SIDS风险提供了一种简单方法。

结论

一个使用母亲特征和出生结局的模型可预测SIDS风险。该模型以简单形式呈现,允许计算个体SIDS风险。

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