National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA.
Matern Child Health J. 2011 Jan;15(1):29-41. doi: 10.1007/s10995-010-0570-2.
We examined trends in low birth weight (LBW, <2,500 g) rates among US singleton non-Hispanic black infants between 1991 and 2004. We conducted Joinpoint regression analyses, using birth certificate data, to describe trends in LBW, moderately LBW (MLBW, 1,500-2,499 g), and very LBW (VLBW, <1,500 g) rates. We then conducted cross-sectional and binomial regression analyses to relate these trends to changes in maternal or obstetric factors. Non-Hispanic black LBW rates declined -7.35% between 1991 and 2001 and then increased +4.23% through 2004. The LBW trends were not uniform across birth weight subcategories. Among MLBW births, the 1991-2001 decease was -10.20%; the 2001-2004 increase was +5.61%. VLBW did not follow this pattern, increasing +3.84% between 1991 and 1999 and then remaining relatively stable through 2004. In adjusted models, the 1991-2001 MLBW rate decrease was associated with changes in first-trimester prenatal care, cigarette smoking, education levels, maternal foreign-born status, and pregnancy weight gain. The 2001-2004 MLBW rate increase was independent of changes in observed maternal demographic characteristics, prenatal care, and obstetric variables. Between 1991 and 2001, progress occurred in reducing MLBW rates among non-Hispanic black infants. This progress was not maintained between 2001 and 2004 nor did it occur for VLBW infants between 1991 and 2004. Observed population changes in maternal socio-demographic and health-related factors were associated with the 1991-2001 decrease, suggesting multiple risk factors need to be simultaneously addressed to reduce non-Hispanic black LBW rates.
我们考察了 1991 年至 2004 年期间美国非西班牙裔黑人单胎婴儿中低出生体重（LBW，<2,500 克）发生率的变化趋势。我们使用出生证明数据进行 Joinpoint 回归分析，以描述 LBW、中低出生体重（MLBW，1,500-2,499 克）和极低出生体重（VLBW，<1,500 克）发生率的变化趋势。然后，我们进行了横断面和二项式回归分析，以研究这些趋势与产妇或产科因素变化的关系。非西班牙裔黑人 LBW 发生率在 1991 年至 2001 年间下降了-7.35%，然后在 2004 年又上升了+4.23%。LBW 趋势在不同的出生体重亚类中并不均匀。在 MLBW 分娩中，1991-2001 年的下降幅度为-10.20%；2001-2004 年的上升幅度为+5.61%。VLBW 则没有遵循这种模式，1991 年至 1999 年增加了+3.84%，然后在 2004 年保持相对稳定。在调整后的模型中，1991-2001 年 MLBW 率的下降与孕早期产前保健、吸烟、教育水平、产妇外国出生身份和妊娠体重增加的变化有关。2001-2004 年 MLBW 率的上升与观察到的产妇人口特征、产前保健和产科变量的变化无关。1991 年至 2001 年间，非西班牙裔黑人婴儿的 MLBW 率有所下降，这一进展在 2001 年至 2004 年间并未得到维持，VLBW 婴儿也未出现这种情况。产妇社会人口统计学和与健康相关的因素的观察到的人口变化与 1991-2001 年的下降有关，这表明需要同时解决多个危险因素，以降低非西班牙裔黑人 LBW 率。
