Department of Epidemiology and Biostatistics, Michigan State University, East Lansing.
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing.
Ann Epidemiol. 2017 Nov;27(11):689-694.e4. doi: 10.1016/j.annepidem.2017.10.005. Epub 2017 Oct 14.
To estimate changes in preterm delivery (PTD) in the United States from 2006 to 2012 by clinical circumstance, timing of delivery, and race/ethnicity.
We used vital statistics natality data on all singleton live births from the 18 U.S. states continuously using the 2003 birth certificate from 2006 to 2012. We estimated change in PTD overall and by clinical circumstance (spontaneous vs. medically indicated) and delivery timing among all women and by race/ethnicity, using descriptive and multivariable regression methods.
Overall, indicated, and spontaneous PTD declined by 10.31%, 8.40%, and 11.52%, respectively. Late-preterm, early-term, and post-term deliveries decreased substantially (12.13%, 18.37%, and 32.20%, respectively), with simultaneous increase (13.57%) in full-term deliveries. Non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander women experienced larger declines in PTD compared with Hispanic and American Indian/Alaska Native women. Non-Hispanic white women experienced larger declines in late and medically indicated PTD, while non-Hispanic black women experienced larger declines in early and moderate and spontaneous PTD.
Overall, spontaneous, and indicated PTD declined from 2006 to 2012. Declines were lower than previously reported and differed substantially by race/ethnicity.
通过临床情况、分娩时机和种族/民族，估计 2006 年至 2012 年美国早产（PTD）的变化。
我们使用来自美国 18 个州的所有单胎活产儿的生命统计出生率数据，使用 2003 年出生证明从 2006 年到 2012 年连续使用。我们通过描述性和多变量回归方法，估计了所有女性和所有女性的早产总体变化以及临床情况（自发性与医学指示性）和分娩时机，种族/民族。
总体而言，指示性和自发性 PTD 分别下降了 10.31%、8.40%和 11.52%。晚期早产、早期早产和晚期早产大幅度下降（分别为 12.13%、18.37%和 32.20%），同期足月分娩增加（13.57%）。与西班牙裔和美洲印第安人/阿拉斯加原住民女性相比，非西班牙裔白人、非西班牙裔黑人和亚洲/太平洋岛民女性的 PTD 下降幅度更大。非西班牙裔白人女性的晚期和医学指示性 PTD 下降幅度较大，而非西班牙裔黑人女性的早期和中度自发性 PTD 下降幅度较大。
总体而言，2006 年至 2012 年自发性和指示性 PTD 下降。下降幅度低于之前的报告，并且在种族/民族方面存在显著差异。
