Bruckner T A, Carlo W A, Ambalavanan N, Gould J B
Department of Epidemiology, School of Public Health, University of California at Berkeley, CA 94704, USA.
J Perinatol. 2008 Oct;28(10):691-5. doi: 10.1038/jp.2008.72. Epub 2008 Jul 3.
Proper management of very low weight (<1500 g) infants requires specific expertise. During July and August, pediatric interns start new rotations and advance in responsibilities by postgraduate level. We test the hypothesis that low weight births in teaching hospitals exhibit increased neonatal mortality during the initial training months.
Population-based cohort of 5184 very low weight and 15 232 moderately low weight infants in California from 19 regional teaching hospitals with medical training programs. Logistic regression methods controlled for both individual covariates and temporal patterns in neonatal mortality.
We found no difference in neonatal mortality between very low weight infants born in teaching hospitals during July and August and those born in other months (adjusted odds ratio (AOR): 0.98, 95% confidence interval (CI), 0.78 to 1.23). Investigation of moderately low birth weight infants also indicated no increased neonatal mortality.
Infants most likely to die in the neonatal period do not appear to be at elevated risk of neonatal mortality during July and August.
对极低体重(<1500克)婴儿进行恰当管理需要特定的专业知识。在7月和8月期间,儿科实习生开始新的轮转,并根据研究生水平提升职责。我们检验这样一个假设,即教学医院中低体重儿出生在最初培训月份时新生儿死亡率会升高。
对加利福尼亚州19家设有医学培训项目的地区教学医院的5184例极低体重儿和15232例中度低体重儿进行基于人群的队列研究。逻辑回归方法对新生儿死亡率中的个体协变量和时间模式进行了控制。
我们发现7月和8月在教学医院出生的极低体重儿与其他月份出生的极低体重儿在新生儿死亡率上没有差异(调整优势比(AOR):0.98,95%置信区间(CI),0.78至1.23)。对中度低体重儿的调查也表明新生儿死亡率没有升高。
在7月和8月,最有可能在新生儿期死亡的婴儿似乎没有更高的新生儿死亡风险。