Schempf Ashley H, Branum Amy M, Lukacs Susan L, Schoendorf Kenneth C
Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
Paediatr Perinat Epidemiol. 2007 Jan;21(1):34-43. doi: 10.1111/j.1365-3016.2007.00785.x.
There is a well-known interaction between maternal age and parity in the risk of adverse perinatal outcomes, including preterm birth (PTB), such that young multiparae and older primiparae have greater risks. Yet it is not known whether this interaction varies by race/ethnicity. US birth records for singleton births from 2000 to 2002 were used to examine the incidence of PTB by maternal age and parity within non-Hispanic White, non-Hispanic Black and Hispanic subgroups. PTB was categorised as moderately (32-36 weeks), very (28-31 weeks), or extremely (<28 weeks) preterm. Odds ratios of PTB according to age and parity were calculated in racial/ethnic specific multinomial logistic regression models. Within each race/ethnicity, comparisons were made relative to 25- to 29-year-old primiparae. Young teenagers (<18), particularly multiparae, generally had a higher risk of each degree of PTB among all three racial/ethnic groups. However, Black teenagers did not have a higher risk of extremely PTB. For very and extremely PTB, teenagers had considerably higher risk among Whites than Blacks or Hispanics. Within each racial/ethnic group, older (35+ years) primiparae had similarly higher risk of each category of PTB relative to 25- to 29-year-old primiparae. Older multiparae had higher risk of moderately and very PTB among Black and Hispanic women only. Adjustment for education did not alter these findings. Teenagers and older primiparae are already widely regarded as having greater perinatal risks. This study suggests that, among Black and Hispanic women, older multiparae may also have a higher risk of moderately and very PTB.
在包括早产（PTB）在内的不良围产期结局风险中，母亲年龄和产次之间存在一种众所周知的相互作用，即年轻经产妇和高龄初产妇的风险更高。然而，尚不清楚这种相互作用是否因种族/族裔而异。利用2000年至2002年美国单胎出生记录，研究非西班牙裔白人、非西班牙裔黑人和西班牙裔亚组中按母亲年龄和产次划分的PTB发生率。PTB分为中度早产（32 - 36周）、重度早产（28 - 31周）或极重度早产（<28周）。在种族/族裔特异性多项逻辑回归模型中计算根据年龄和产次的PTB优势比。在每个种族/族裔群体中，与25至29岁的初产妇进行比较。年轻青少年（<18岁），尤其是经产妇，在所有三个种族/族裔群体中，每种程度的PTB风险通常都更高。然而，黑人青少年极重度早产的风险并不更高。对于重度和极重度早产，青少年在白人中的风险比黑人和西班牙裔高得多。在每个种族/族裔群体中，年龄较大（35岁及以上）的初产妇相对于25至29岁的初产妇，每种类型的PTB风险同样更高。仅在黑人和西班牙裔女性中，年龄较大的经产妇中度和重度早产的风险更高。调整教育因素并没有改变这些结果。青少年和高龄初产妇已经被广泛认为具有更高的围产期风险。这项研究表明，在黑人和西班牙裔女性中，年龄较大的经产妇中度和重度早产的风险也可能更高。
