Rosenstein Melissa G, Snowden Jonathan M, Cheng Yvonne W, Caughey Aaron B
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA.
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR.
Am J Obstet Gynecol. 2014 Dec;211(6):660.e1-8. doi: 10.1016/j.ajog.2014.06.008. Epub 2014 Jun 5.
The objective of the study was to compare the mortality risk of expectant management with the risk of delivery at each week of term pregnancy in 4 racial/ethnic groups.
This was a retrospective cohort study of all nonanomalous, term deliveries in California from 1997 to 2006 among white, black, Hispanic, and Asian women. In each racial/ethnic group, we compared the risk of infant death at each week with a composite risk representing the mortality risk of 1 week of expectant management.
The risk of stillbirth and infant death is highest in black women (stillbirth risk: 18.0 per 10,000, infant death: 24.4 per 10,000, compared with 9.4 per 10,000 and 10.8 per 10,000 in white women, respectively; P < .001). Although absolute risks differ by race/ethnicity, the composite risk of expectant management does not surpass the risk of delivery until 39 weeks in any group. At 39 weeks these absolute risk differences are low, however, with a number needed to deliver to prevent 1 death ranging from 751 (among black women) to 2587 (among Asian women).
The mortality risk of expectant management exceeds the risk of delivery at 39 weeks in all racial/ethnic groups, despite variation in absolute risks.
本研究的目的是比较4个种族/族裔群体中期待治疗的死亡风险与足月妊娠各孕周分娩的风险。
这是一项对1997年至2006年加利福尼亚州所有白人、黑人、西班牙裔和亚洲女性的非异常足月分娩进行的回顾性队列研究。在每个种族/族裔群体中，我们将每周的婴儿死亡风险与代表1周期待治疗死亡风险的综合风险进行了比较。
黑人女性的死产和婴儿死亡风险最高（死产风险：每10000例中有18.0例，婴儿死亡：每10000例中有24.4例，相比之下，白人女性分别为每10000例中有9.4例和10.8例；P <.001）。尽管绝对风险因种族/族裔而异，但在任何组中，期待治疗的综合风险直到39周才超过分娩风险。然而，在39周时，这些绝对风险差异较小，预防1例死亡所需的分娩数从751例（黑人女性中）到2587例（亚洲女性中）不等。
尽管绝对风险存在差异，但在所有种族/族裔群体中，期待治疗的死亡风险在39周时超过了分娩风险。
