From the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; the March of Dimes, White Plains, New York; and the U.S. Food and Drug Administration, Silver Spring, Maryland.
Obstet Gynecol. 2011 Jun;117(6):1279-1287. doi: 10.1097/AOG.0b013e3182179e28.
To estimate the trend of maternal racial and ethnic differences in mortality for early-term (37 0/7 to 38 6/7 weeks of gestation) compared with full-term births (39 0/7 to 41 6/7 weeks of gestation).
We analyzed 46,329,018 singleton live births using the National Center for Health Statistics U.S. period-linked birth and infant death data from 1995 to 2006. Infant mortality rates, neonatal mortality rates, and postneonatal mortality rates were calculated according to gestational age, race and ethnicity, and cause of death.
Overall, infant mortality rates have decreased for early-term and full-term births between 1995 and 2006. At 37 weeks of gestation, Hispanics had the greatest decline in infant mortality rates (35.4%; 4.8 per 1,000 to 3.1 per 1,000) followed by 22.4% for whites (4.9 per 1,000 to 3.8 per 1,000); blacks had the smallest decline (6.8%; 5.9 per 1,000 to 5.5 per 1,000) as a result of a stagnant neonatal mortality rate. At 37 weeks compared with 40 weeks of gestation, neonatal mortality rates increase. For Hispanics, the relative risk is 2.6 (95% confidence interval [CI] 2.0-3.3); for whites, the relative risk is 2.6 (95% CI 2.2-3.1); and for blacks, the relative risk is 2.9 (95% CI 2.2-3.8). Neonatal mortality rates are still increased at 38 weeks of gestation. At both early- and full-term gestations, neonatal mortality rates for blacks are 40% higher than for whites and postneonatal mortality rates 80% higher, whereas Hispanics have a reduced postneonatal mortality rate when compared with whites.
Early-term births are associated with higher neonatal, postneonatal, and infant mortality rates compared with full-term births with concerning racial and ethnic disparity in rates and trends.
估计与足月（39 周零 7 天至 41 周零 6 天）相比，早期（37 周零 7 天至 38 周零 6 天）产妇的种族和民族死亡率的趋势。
我们分析了 1995 年至 2006 年美国国家卫生统计中心（National Center for Health Statistics）的全国与妊娠相关的出生和婴儿死亡数据中 46329018 例单胎活产儿。根据胎龄、种族和民族以及死因计算婴儿死亡率、新生儿死亡率和围生后死亡率。
总体而言，1995 年至 2006 年期间，早期和足月分娩的婴儿死亡率均有所下降。在 37 孕周时，西班牙裔的婴儿死亡率下降幅度最大（35.4%；每 1000 例中 4.8 例降至每 1000 例 3.1 例），其次是白人（4.9 例降至每 1000 例 3.8 例）；黑人的下降幅度最小（6.8%；每 1000 例中 5.9 例降至每 1000 例 5.5 例），因为新生儿死亡率保持稳定。与 40 孕周相比，37 孕周的新生儿死亡率增加。对于西班牙裔，相对风险为 2.6（95%置信区间[CI]为 2.0-3.3）；对于白人，相对风险为 2.6（95% CI 为 2.2-3.1）；对于黑人，相对风险为 2.9（95% CI 为 2.2-3.8）。38 孕周的新生儿死亡率仍升高。在早期和足月妊娠中，黑人的新生儿死亡率比白人高 40%，围生后死亡率高 80%，而与白人相比，西班牙裔的围生后死亡率降低。
与足月分娩相比，早期分娩与新生儿、围生后和婴儿死亡率较高相关，且种族和民族之间的差异在比率和趋势上令人担忧。
