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布宜诺斯艾利斯自治市先天性畸形导致的婴儿死亡率(1998 - 2015年):空间、时间分析及其与社会经济地位的关系

Infant mortality due to congenital malformations in the Autonomous City of Buenos Aires (1998-2015): Spatial, temporal analysis and relation to the socioeconomic status.

作者信息

Bronberg Rubén A, Dipierri José E

机构信息

Área de Genética Médica y Poblacional, Sección Neonatología, Departamento Materno-infantojuvenil, Hospital General de Agudos Dr. J. M. Ramos Mejía, Ciudad de Buenos Aires.

Instituto de Biología de la Altura, Universidad Nacional de Jujuy, San Salvador de Jujuy.

出版信息

Arch Argent Pediatr. 2019 Jun 1;117(3):171-178. doi: 10.5546/aap.2019.eng.171.

Abstract

INTRODUCTION

In Argentina, congenital malformations (CM) account for the second cause of death among infants younger than 1 year.

OBJECTIVE

To analyze spatial and temporal variation in infant mortality due to CM in the Autonomous City of Buenos Aires and its relation to a socioeconomic development indicator.

MATERIALS AND METHODS

Births and deaths among infants younger than 1 year were coded using the International Classification of Diseases (ICD-10); data were provided by the Ministry of Health. Geographical areas: northern, central and southern. The nervous system, the cardiovascular system, chromosomal abnormalities, and 28 specific malformations were evaluated. Infant mortality rate due to CM (IMR-CM) and the percentage of deaths from CM (PD-CM) were estimated in 3 periods (1998-2003, 2004-2009, 2010-2015). Secular trend and risk of death were estimated using the Poisson regression model. A socioeconomic development indicator correlated to the IMR-CM and the PD-CM was obtained by means of a principal component analysis.

RESULTS

The IMR-CM and the PD-CM had, respectively, a negative and positive secular trend with statistical significance, and exhibited a differentiation by areas. The IMR-CM values decreased for central nervous system and cardiovascular system malformations, and increased for chromosomal abnormalities (p < 0.05). The IMR-CM and the PD-CM were positively and negatively correlated, respectively, with the socioeconomic indicator (p < 0.05).

CONCLUSION

Infant mortality indicators due to CM in the Autonomous City of Buenos Aires are spatially and temporally heterogeneous, and are related to the socioeconomic characteristics of the areas.

摘要

引言

在阿根廷,先天性畸形(CM)是1岁以下婴儿死亡的第二大原因。

目的

分析布宜诺斯艾利斯自治市因先天性畸形导致的婴儿死亡率的时空变化及其与社会经济发展指标的关系。

材料与方法

使用国际疾病分类(ICD-10)对1岁以下婴儿的出生和死亡进行编码;数据由卫生部提供。地理区域:北部、中部和南部。对神经系统、心血管系统、染色体异常以及28种特定畸形进行了评估。在三个时期(1998 - 2003年、2004 - 2009年、2010 - 2015年)估算了因先天性畸形导致的婴儿死亡率(IMR-CM)和先天性畸形死亡百分比(PD-CM)。使用泊松回归模型估算长期趋势和死亡风险。通过主成分分析获得与IMR-CM和PD-CM相关的社会经济发展指标。

结果

IMR-CM和PD-CM分别具有统计学意义的负向和正向长期趋势,并呈现出区域差异。中枢神经系统和心血管系统畸形的IMR-CM值下降,而染色体异常的IMR-CM值上升(p < 0.05)。IMR-CM和PD-CM分别与社会经济指标呈正相关和负相关(p < 0.05)。

结论

布宜诺斯艾利斯自治市因先天性畸形导致的婴儿死亡率指标在时空上具有异质性,且与各区域的社会经济特征相关。

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