婴儿期住院治疗：巴西南部一城市三十年不平等现象研究。

Hospital admissions in the first year of life: inequalities over three decades in a southern Brazilian city.

机构信息

Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.

Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.

出版信息

Int J Epidemiol. 2019 Apr 1;48(Suppl 1):i63-i71. doi: 10.1093/ije/dyy228.

DOI:10.1093/ije/dyy228

PMID:30883660

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6422058/

Abstract

BACKGROUND

Hospital admissions in infancy are declining in several countries. We describe admissions to neonatal intensive care units (NICU) and other hospitalizations over a 33-year period in the Brazilian city of Pelotas.

METHODS

We analysed data from four population-based birth cohorts launched in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. NICU and other hospital admissions during infancy were reported by the mothers in the perinatal interview and at the 12-month visit, respectively. We describe these outcomes by sex of the child, family income and maternal skin colour.

RESULTS

In 1982, NICUs did not exist in the city; admissions into NICUs increased from 2.7% of all newborns in 1993 to 6.7% in 2015, and admission rates were similar in all income groups. Hospitalizations during the first year of life fell by 29%, from 23.7% in 1982 to 16.8% in 2015, and diarrhoea admissions fell by 95.2%. Pneumonia admissions fell by 46.3% from 1993 to 2015 (no data available for 1982). Admissions due to perinatal causes increased during the period. In the poorest income quintile, total admissions fell by 33% (from 35.7% to 23.9%), but in the richest quintile these remained stable at around 10%, leading to a reduction in inequalities. Over the whole period, children born to women with black or brown skin were 30% more likely to be admitted than those of white-skinned mothers.

CONCLUSIONS

Whereas NICU admissions increased, total admissions in the first year of life declined by nearly one-third. Socioeconomic disparities were reduced, but important gaps remain.

摘要

背景

在一些国家，婴儿住院人数正在下降。我们描述了巴西佩洛塔斯市在 33 年期间新生儿重症监护病房（NICU）和其他住院治疗的入院情况。

方法

我们分析了 1982 年、1993 年、2004 年和 2015 年启动的四项基于人群的出生队列的数据，每个队列都包括当年的所有医院出生人数。NICU 和婴儿期其他住院治疗的入院情况分别由围产期访谈和 12 个月访视中的母亲报告。我们按儿童的性别、家庭收入和母亲的肤色描述这些结果。

结果

1982 年，该市没有 NICU；NICU 入院率从 1993 年的所有新生儿的 2.7%增加到 2015 年的 6.7%，且所有收入群体的入院率相似。婴儿期第一年的住院率下降了 29%，从 1982 年的 23.7%下降到 2015 年的 16.8%，腹泻入院率下降了 95.2%。肺炎入院率从 1993 年到 2015 年下降了 46.3%（1982 年没有数据）。在此期间，由于围产期原因的入院人数增加。在最贫穷的五分之一收入群体中，总入院率下降了 33%（从 35.7%降至 23.9%），但在最富有五分之一的群体中，这些比率保持稳定，约为 10%，从而减少了不平等现象。在整个时期内，与白人母亲的孩子相比，皮肤颜色为黑色或棕色的母亲的孩子入院的可能性要高 30%。