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母体外暴露海拔高度与婴儿出生体重的准实验分析。

A quasi-experimental analysis of maternal altitude exposure and infant birth weight.

机构信息

Sammy Zahran and Bruce G. Link are with the Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY. Ian M. Breunig is with the Pharmaceutical Health Services Research Department, University of Maryland, School of Pharmacy, Baltimore. Jeffrey G. Snodgrass is with the Department of Anthropology, and Stephan Weiler is with the Department of Economics, Colorado State University, Fort Collins.

出版信息

Am J Public Health. 2014 Feb;104 Suppl 1(Suppl 1):S166-74. doi: 10.2105/AJPH.2013.301725. Epub 2013 Dec 19.

Abstract

OBJECTIVES

We analyzed singleton births to determine the relationship between birth weight and altitude exposure.

METHODS

We analyzed 715,213 singleton births across 74 counties from the western states of Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, and Washington from January 1, 2000, to December 31, 2000. Birth data were obtained from the Division of Vital Statistics, National Center for Health Statistics, for registered births.

RESULTS

Regression analyses supported previous research by showing that a 1000-meter increase in maternal altitude exposure in pregnancy was associated with a 75.9-gram reduction in birth weight (95% confidence interval = -84.1, -67.6). Quantile regression models indicated significant and near-uniform depressant effects from altitude exposure across the conditional distribution of birth weight. Bivariate sample-selection models showed that a 1000-meter increase in altitude exposure, over and above baseline residential altitude, decreased birth weight by an additional 58.8 grams (95% confidence interval = -98.4, -19.2).

CONCLUSIONS

Because of calculable health care-related costs associated with lower birth weight, our reported results might be of interest to clinicians practicing at higher altitudes.

摘要

目的

我们分析了单胎分娩,以确定出生体重与海拔暴露之间的关系。

方法

我们分析了 2000 年 1 月 1 日至 12 月 31 日期间来自亚利桑那州、加利福尼亚州、科罗拉多州、爱达荷州、蒙大拿州、内华达州、新墨西哥州、俄勒冈州、犹他州和华盛顿州的 74 个县的 715213 例单胎分娩。出生数据来自国家健康统计中心生命统计司的注册出生数据。

结果

回归分析支持了先前的研究,表明妊娠期间母亲海拔每升高 1000 米,出生体重就会降低 75.9 克(95%置信区间为-84.1,-67.6)。分位数回归模型表明,海拔暴露对出生体重的条件分布有显著且近乎均匀的抑制作用。二元样本选择模型显示,在基线居住海拔的基础上,海拔每升高 1000 米,出生体重就会额外降低 58.8 克(95%置信区间为-98.4,-19.2)。

结论

由于与低出生体重相关的可计算医疗保健成本,我们报告的结果可能会引起在高海拔地区行医的临床医生的兴趣。

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