Collier Sarah A, Hogue Carol J R
Department of Epidemiology, Rollins School of Public Health, Women's and Children's Center, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
Matern Child Health J. 2007 Jan;11(1):65-71. doi: 10.1007/s10995-006-0085-z.
to estimate the effect of modifiable risk factors on low birth weight and two of its sequelae-cerebral palsy and mental retardation.
The population attributable risk percent (PARP) was used as a measure of effect. A literature search was conducted to determine estimates of the percent of CP and MR attributable to low birth weight. Data from the 1996-1997 Georgia Pregnancy Risk Assessment Monitoring System (PRAMS), a population based surveillance system, were used to estimate the percent of low birth weight attributable to modifiable risk factors. The PARP was calculated for smoking and unwanted conception.
Unwanted pregnancy and smoking were statistically significant risk factors for LBW. Four percent of all LBW births were attributable to unwanted pregnancy. If all unwanted pregnancies were prevented, 13% of cases of CP (27 cases per year in GA) and 14% of cases of MR (151 cases per year in GA) would be prevented. In wanted or mistimed pregnancies, 6% of LBW births were attributable to smoking. If all smoking during wanted or mistimed pregnancy was prevented, an additional 2.5% (5 cases) of CP and an additional 0.8% (8 cases) of MR would be prevented in Georgia each year. If all unwanted pregnancies and all smoking during wanted or mistimed pregnancies were prevented, 1692 LBW births could be prevented per year and the rate of LBW in Georgia would fall from 7.6% to 6.8%. Additionally, 32 cases of cerebral palsy and 159 cases of mental retardation could be prevented each year in Georgia.
The PARP approach is useful in estimating the benefit of evidence-based prevention services. Preventing unwanted pregnancy and smoking during pregnancy would substantially reduce the burden of cerebral palsy and mental retardation in Georgia.
评估可改变的风险因素对低出生体重及其两个后遗症——脑瘫和智力迟钝的影响。
人群归因风险百分比（PARP）用作效应指标。通过文献检索确定脑瘫和智力迟钝归因于低出生体重的百分比估计值。利用1996 - 1997年佐治亚州妊娠风险评估监测系统（PRAMS）的数据，该系统是一个基于人群的监测系统，来估计可改变风险因素导致低出生体重的百分比。计算了吸烟和意外怀孕的PARP。
意外怀孕和吸烟是低出生体重的统计学显著风险因素。所有低出生体重儿中有4%归因于意外怀孕。如果所有意外怀孕都能避免，那么13%的脑瘫病例（佐治亚州每年27例）和14%的智力迟钝病例（佐治亚州每年151例）将可避免。在有计划或时机不当的怀孕中，6%的低出生体重儿归因于吸烟。如果能避免所有有计划或时机不当怀孕期间的吸烟行为，佐治亚州每年将额外避免2.5%（5例）的脑瘫病例和0.8%（8例）的智力迟钝病例。如果能避免所有意外怀孕以及所有有计划或时机不当怀孕期间的吸烟行为，佐治亚州每年可避免1692例低出生体重儿出生，低出生体重率将从7.6%降至6.8%。此外，佐治亚州每年可避免32例脑瘫病例和159例智力迟钝病例。
PARP方法有助于评估循证预防服务的益处。预防意外怀孕和孕期吸烟将大幅减轻佐治亚州脑瘫和智力迟钝的负担。
