Schluter Philip J, Paterson Janis, Percival Teuila
Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand.
J Paediatr Child Health. 2006 Mar;42(3):123-8. doi: 10.1111/j.1440-1754.2006.00810.x.
Child injury is the leading cause of mortality and morbidity in developed countries. While Pacific infant death rates are relatively high in New Zealand, little is known about non-fatal injury rates. We seek to describe maternally reported injury in Pacific infants aged between 0-24 months.
A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. Maternal home interviews were conducted at 6 weeks, 12 months and 24 months postpartum and injury events were recalled. Marginal models using generalized estimating equations (GEEs) were used to analysis the longitudinal data.
The inception cohort included 1398 infants at 6 weeks, 1241 infants at 12 months and 1161 infants at 24 months. The age-specific injury incidence per 1000 person-years exposure was estimated at 48 (95% CI: 23, 88) injuries for infants aged 0-6 weeks, 106 (95% CI: 88, 127) injuries for infants aged 7 weeks-12 months and 174 (95% CI: 151, 199) injuries for infants aged 13-24 months. In the multivariable GEE model, older infants (P < 0.001), infants who were male (P = 0.01), born to Pacific Island fathers and non-Pacific Island mothers (P < 0.001), and in higher or unknown income groups (P = 0.01) were significantly more likely to suffer injury events. No significant two-factor interaction with infant age was identified.
Among Pacific infants, non-fatal injury is common and injury incidence rates are considerably higher than national levels. Male infants and those born into ethnically mixed families, where the father was of Pacific Island ethnicity and the mother was non-Pacific, were at increased relative risk of injury and might benefit from specific injury prevention targeting. However, given the high injury incidence levels found, we advocate that investigation and targeting of culturally appropriate prevention strategies for all Pacific families with young children is required to reduce injury rates for Pacific infants in New Zealand.
儿童伤害是发达国家死亡和发病的主要原因。虽然在新西兰太平洋岛屿婴儿死亡率相对较高，但对于非致命伤害率却知之甚少。我们试图描述母亲报告的0至24个月大的太平洋岛屿婴儿的伤害情况。
对2000年在新西兰奥克兰出生的一组太平洋岛屿婴儿进行跟踪研究。在产后6周、12个月和24个月时对母亲进行家访，并回忆伤害事件。使用广义估计方程（GEEs）的边际模型来分析纵向数据。
起始队列在6周时包括1398名婴儿，12个月时为1241名婴儿，24个月时为1161名婴儿。每1000人年暴露的特定年龄伤害发病率估计为：0至6周龄婴儿为48例（95%置信区间：23，88），7周龄至12个月龄婴儿为106例（95%置信区间：88，127），13至24个月龄婴儿为174例（95%置信区间：151，199）。在多变量GEE模型中，年龄较大的婴儿（P < 0.001）、男性婴儿（P = 0.01）、父亲为太平洋岛屿族裔且母亲为非太平洋岛屿族裔的婴儿（P < 0.001）以及收入较高或情况不明的群体中的婴儿（P = 0.01）遭受伤害事件的可能性显著更高。未发现与婴儿年龄有显著的双因素交互作用。
在太平洋岛屿婴儿中，非致命伤害很常见，伤害发病率远高于全国水平。男婴以及父亲为太平洋岛屿族裔而母亲为非太平洋岛屿族裔的混血家庭出生的婴儿，受伤的相对风险增加，可能会从针对性的预防伤害措施中受益。然而，鉴于发现的高伤害发病率水平，我们主张需要对所有有幼儿的太平洋岛屿家庭进行调查，并制定适合其文化的预防策略，以降低新西兰太平洋岛屿婴儿的伤害率。
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