Willinger Marian, Ko Chia-Wen, Reddy Uma M
Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Am J Obstet Gynecol. 2009 Nov;201(5):469.e1-8. doi: 10.1016/j.ajog.2009.06.057. Epub 2009 Sep 17.
We sought to determine factors associated with racial disparities in stillbirth risk.
Stillbirth hazard was analyzed using 5,138,122 singleton gestations from the National Center of Health Statistics perinatal mortality and birth files, 2001-2002.
Black women have a 2.2-fold increased risk of stillbirth compared with white women. The black/white disparity in stillbirth hazard at 20-23 weeks is 2.75, decreasing to 1.57 at 39-40 weeks. Higher education reduced the hazard for whites more than for blacks and Hispanics. Medical, pregnancy, and labor complications accounted for 30% of the hazard in blacks and 20% in whites and Hispanics. Congenital anomalies and small for gestational age contributed more to preterm stillbirth risk among whites than blacks. Pregnancy and labor conditions contributed more to preterm stillbirth risk among blacks than whites.
The excess stillbirth risk for blacks was greatest at preterm gestations, and factors contributing to stillbirth risk vary by race and gestational age.
我们试图确定与死产风险种族差异相关的因素。
利用美国国家卫生统计中心2001 - 2002年围产期死亡率和出生记录中的5138122例单胎妊娠分析死产风险。
与白人女性相比，黑人女性的死产风险增加了2.2倍。20 - 23周时黑人/白人死产风险差异为2.75，在39 - 40周时降至1.57。高等教育对白人死产风险的降低作用比对黑人和西班牙裔更大。医疗、妊娠和分娩并发症在黑人死产风险中占30%，在白人和西班牙裔中占20%。先天性异常和小于胎龄儿对白人早产死产风险的影响大于黑人。妊娠和分娩情况对黑人早产死产风险的影响大于白人。
黑人在早产时的额外死产风险最高，且导致死产风险的因素因种族和孕周而异。
