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极低出生体重早产儿的患病率、死亡率及相关危险因素:33 年分析。

Prevalence, mortality and risk factors associated with very low birth weight preterm infants: an analysis of 33 years.

机构信息

Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Hospital São Lucas, Programa de Pós-Graduação em Pediatria e Saúde da Criança, Porto Alegre, RS, Brazil.

Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil.

出版信息

J Pediatr (Rio J). 2020 May-Jun;96(3):327-332. doi: 10.1016/j.jped.2018.10.011. Epub 2018 Dec 12.

Abstract

OBJECTIVE

To assess the prevalence, mortality and risk factors associated with the birth of very low birth weight preterm infants over a period of 33 years.

METHODS

Four cross-sectional studies were analyzed, using data from perinatal interviews of birth cohorts in the city of Pelotas collected in 1982, 1993, 2004, and 2015. Based on perinatal questionnaires, anthropometric measurements of newborns and death certificates were analyzed to obtain the prevalence rate, neonatal mortality, and risk factors (maternal age, income and type of delivery) for very low birth weight.

RESULTS

A total of 19,625 newborns were included in the study. In the years 1982, 1993, 2004, and 2015, there were, respectively, 5909, 5232, 4226, and 4258 births. The prevalence of very low birth weight was, respectively, 1.1% (n=64), 0.9% (n=46), 1.4% (n=61), and 1.3% (n=54). There was no statistical evidence of an increasing trend over time (p=0.11). Among the risk factors, family income in the three poorest quintiles was associated with prevalence rates that were approximately twice as high as in the richest quintile (p=0.003). Mortality per 1000 live births for neonates weighing <1500g decreased from 688 to 259 per thousand from 1982 to 2015 (p<0.001), but still represented 61% of neonatal deaths in the latter year.

CONCLUSION

Although mortality in very low birth weight decreased by more than 60% in recent years, this group still contributes with more than half of neonatal deaths. Low family income remains an important risk factor in this scenario.

摘要

目的

评估 33 年来极低出生体重早产儿的发生率、死亡率和相关危险因素。

方法

对该市 1982 年、1993 年、2004 年和 2015 年出生队列的围产期访谈数据进行了 4 项横断面研究。基于围产期问卷、新生儿的人体测量值和死亡证明分析,得出极低出生体重的发生率、新生儿死亡率和危险因素(母亲年龄、收入和分娩方式)。

结果

共有 19625 名新生儿纳入研究。1982 年、1993 年、2004 年和 2015 年,极低出生体重的发生率分别为 1.1%(64 例)、0.9%(46 例)、1.4%(61 例)和 1.3%(54 例)。从统计学上看,没有证据表明发生率随时间呈上升趋势(p=0.11)。在这些危险因素中,家庭收入处于前 3 个最贫穷五分位数的新生儿与最富裕五分位数的新生儿相比,其发生率约为后者的两倍(p=0.003)。1982 年至 2015 年,出生体重<1500g 的新生儿每 1000 例活产的死亡率从 688 例降至 259 例(p<0.001),但在后者中仍占新生儿死亡的 61%。

结论

尽管近年来极低出生体重儿的死亡率下降了 60%以上,但这一群体仍导致了一半以上的新生儿死亡。低家庭收入仍然是这一情况下的一个重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1675/9432241/5fc93b920f58/gr1.jpg

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