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[巴西活产信息系统(SINASC)中孕周评估的准确性:一项人群研究]

[Accuracy of gestational age assessment in Brazilian Information System on Live Birth (SINASC): a population study].

作者信息

Henriques Licia Barbosa, Alves Erika Barreto, Vieira Fernanda Morena Dos Santos Barbeiro, Cardoso Bruno Baptista, D'Angeles Adriana Cristina Rodrigues, Cruz Oswaldo Gonçalves, Silva Monique Felix Ribeiro da, Saraceni Valeria

机构信息

Faculdade Vale do Cricaré, São Mateus, Brasil.

Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2019 Apr 8;35(3):e00098918. doi: 10.1590/0102-311X00098918.

Abstract

The prevalence of preterm births has shown a growing trend in many countries, including developed ones. Studies in Brazil have shown that the Information System on Live Births (SINASC, in Portuguese), until 2010, underestimated the prevalence of preterm births, when compared with studies based on primary data. Starting in 2011, gestational age at birth has been calculated in SINASC according to the last menstrual period (LMP), when available. This study sought to evaluate the accuracy of the gestational age assessment using LMP, compared with two other estimates, and correlate it with birth weight. This is a population study with data from SINASC available from Brazilian Health Informatics Department between 2011 and 2015. Definitions of preterm birth, low birth weight and birth asphyxia were taken from the literature. Adequacy of birth weigh to gestational age was calculated based on Fenton and Intergrowth-21 curves. We compared weight means according to the presence or lack of preterm birth. gestational age assessment was based on LMP in 58.5% and 41.5% used another method. We found that the preterm proportion was 12% in the LMP group and 8.4% in the other method group, while low birth weight was 6.5% and 8.4%, respectively. Mean weight of preterm infants was higher in the LMP group. Use of LMP as a gestational age estimator overestimated the proportion of weight equal to or higher than 2,500g among preterm infants, which does not seem compatible with the expected distribution for this group. LMP favored "correction" of prematurity for the parameters that are comparable to those of primary data studies, though the distortions we found between gestational age and birth weigh may indicate that there are still problems with this estimator.

摘要

包括发达国家在内,许多国家的早产发生率都呈上升趋势。巴西的研究表明,直到2010年,与基于原始数据的研究相比,活产信息系统(葡萄牙语为SINASC)低估了早产发生率。从2011年开始,SINASC根据末次月经日期(LMP)(如有)计算出生时的孕周。本研究旨在评估使用LMP评估孕周的准确性,并与其他两种估计方法进行比较,同时将其与出生体重相关联。这是一项基于巴西卫生信息部门2011年至2015年期间SINASC数据的人群研究。早产、低出生体重和出生窒息的定义均来自文献。根据Fenton曲线和Intergrowth-21曲线计算出生体重与孕周的适配情况。我们比较了有无早产情况下的体重均值。孕周评估中,58.5%基于LMP,41.5%使用其他方法。我们发现,LMP组的早产比例为12%,其他方法组为8.4%;低出生体重比例分别为6.5%和8.4%。LMP组早产婴儿的平均体重更高。将LMP用作孕周估计方法时,高估了早产婴儿中体重等于或高于2500g的比例,这似乎与该组的预期分布不相符。尽管我们发现孕周和出生体重之间存在偏差,但LMP在与原始数据研究可比的参数方面有利于对早产进行“校正”,这可能表明该估计方法仍存在问题。

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