Battin Malcolm R, McCowan Lesley M E, George-Haddad Maha, Thompson John M D
Department of Paediatrics, University of Auckland, and National Women's Health, Auckland City Hospital, New Zealand.
Aust N Z J Obstet Gynaecol. 2007 Dec;47(6):457-63. doi: 10.1111/j.1479-828X.2007.00779.x.
There are few studies of risk factors for neonatal death in Australia or New Zealand.
To assess in a cohort of neonatal deaths (i) the demographic and clinical risk factors; (ii) the relationship between low weight for gestation using population and customised centiles; and (iii) the cause of death by the Perinatal Society of Australia and New Zealand Perinatal and Neonatal death classifications.
A retrospective study of 410 babies who died, in the neonatal period, at National Women's Hospital, between 1993 and 2000. Demographic and clinical data were compared with that from a referent population of live births with neonatal deaths removed (n=68 905).
The overall neonatal death rate was 5.9 per 1000 live births and after exclusion of congenital abnormalities was 3.9 per 1000 live births. Infants of Maori women had increased risk compared to European (adjusted odds ration (AOR) 1.52; 95% CI 1.06, 2.18), as did those born to primipara (AOR 1.52; 95% CI 1.10, 2.11), mothers with >or=1 previous low-birthweight baby (AOR 2.97; 95% CI 1.99, 4.44), >or=1 miscarriage (AOR 1.35; 95% CI 1.00, 1.81), and an index multiple pregnancy (AOR 10.51; 95% CI 8.04, 13.76). Infants of Chinese mothers had decreased risk (AOR 0.42; 95% CI 0.18, 0.96). Fifty (34%) babies were small for gestational age by customised and 26 (17%) by population centiles. The most common classification of neonatal death was congenital abnormality (34.6%), followed by extreme prematurity (34.1%).
This study emphasises the importance of suboptimal fetal growth as an important risk factor for neonatal death especially when customised centiles are used.
在澳大利亚或新西兰，关于新生儿死亡风险因素的研究较少。
在一组新生儿死亡病例中评估：（i）人口统计学和临床风险因素；（ii）使用总体百分位数和定制百分位数时，出生体重低于孕周标准的情况之间的关系；（iii）根据澳大利亚和新西兰围产期协会的围产期和新生儿死亡分类确定死亡原因。
对1993年至2000年间在国家妇女医院新生儿期死亡的410例婴儿进行回顾性研究。将人口统计学和临床数据与排除新生儿死亡的活产参考人群（n = 68905）的数据进行比较。
总体新生儿死亡率为每1000例活产5.9例，排除先天性异常后为每1000例活产3.9例。与欧洲裔相比，毛利族妇女所生婴儿的风险增加（调整后的优势比（AOR）为1.52；95%可信区间为1.06, 2.18），初产妇所生婴儿也是如此（AOR为1.52；95%可信区间为1.10, 2.11），有≥1个低体重儿的母亲所生婴儿（AOR为2.97；95%可信区间为1.99, 4.44），有≥1次流产史的母亲所生婴儿（AOR为1.35；95%可信区间为1.00, 1.81），以及单绒毛膜多胎妊娠所生婴儿（AOR为10.51；95%可信区间为8.04, 13.76）。中国母亲所生婴儿的风险降低（AOR为0.42；95%可信区间为0.18, 0.96）。根据定制百分位数，50例（34%）婴儿为小于胎龄儿，根据总体百分位数为26例（17%）。新生儿死亡最常见的分类是先天性异常（34.6%），其次是极早产（34.1%）。
本研究强调了胎儿生长发育不良作为新生儿死亡重要风险因素的重要性，尤其是在使用定制百分位数时。
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