加利福尼亚州妊娠超过41周的正常体重出生儿中新生儿死亡率上升。

Increased neonatal mortality among normal-weight births beyond 41 weeks of gestation in California.

作者信息

Bruckner Tim A, Cheng Yvonne W, Caughey Aaron B

机构信息

Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA.

出版信息

Am J Obstet Gynecol. 2008 Oct;199(4):421.e1-7. doi: 10.1016/j.ajog.2008.05.015. Epub 2008 Jul 17.

DOI:10.1016/j.ajog.2008.05.015

PMID:18639211

Abstract

OBJECTIVE

The purpose of this study was to examine whether postterm gestational age increases the risk of neonatal mortality.

STUDY DESIGN

We retrieved data from 1,815,811 liveborn infants in California from 1999 to 2003. We excluded multiple births and congenital anomalies, as well as infants with a gestational age of less than 38 w0d, or greater than 42 w6d, weeks. We used multivariable logistic regression models to adjust for demographic variables thought to confound the association.

RESULTS

Compared to infants born at 38, 39, or 40 weeks, those born at 41 w0d to 42 w6d have a greater odds of neonatal mortality (aOR: 1.34, 95% CI, 1.08-1.65). Subdividing by gestational week, infants delivered at 41 w0d to 41 w6d showed elevated mortality relative to earlier term births (aOR: 1.37, 95% CI, 1.08-1.73). Additional analyses support this increased neonatal mortality across all normal birthweight categories.

CONCLUSION

Infants born beyond 41 w0d of gestation experience greater neonatal mortality relative to term infants born between 38 w0d and 40 w6d.

摘要

目的

本研究旨在探讨过期妊娠是否会增加新生儿死亡风险。

研究设计

我们检索了1999年至2003年加利福尼亚州1,815,811例活产婴儿的数据。我们排除了多胞胎和先天性异常，以及孕周小于38周0天或大于42周6天的婴儿。我们使用多变量逻辑回归模型来调整被认为会混淆该关联的人口统计学变量。

结果

与在38、39或40周出生的婴儿相比，在41周0天至42周6天出生的婴儿有更高的新生儿死亡几率（校正比值比：1.34，95%置信区间，1.08 - 1.65）。按孕周细分，在41周0天至41周6天出生的婴儿相对于早期足月儿显示出死亡率升高（校正比值比：1.37，95%置信区间，1.08 - 1.73）。进一步分析支持在所有正常出生体重类别中这种新生儿死亡率的增加。