早产对美国婴儿死亡率种族差异的贡献。
Contribution of previable births to infant mortality rate racial disparity in the United States.
机构信息
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
出版信息
J Perinatol. 2019 Sep;39(9):1190-1195. doi: 10.1038/s41372-019-0394-x. Epub 2019 May 14.
OBJECTIVE
To quantify racial differences in contribution of previable live births (<20 weeks gestational age (GA)) to United States (US) Infant Mortality Rates (IMR).
METHODS
Population-based retrospective cohort of US live births (2007-14) using CDC WONDER database stratified by maternal race/ethnicity. We compared the contribution of previable births to IMR and calculated modified IMRs (≥20 weeks GA) excluding previable live births in each group. Contingency tables and chi-square calculations were performed to detect differences between groups.
RESULTS
Previable deaths represented 4.1%, 7.7%, and 5.0% of total deaths for nonHispanic white, nonHispanic black, and Hispanic, respectively. Previable contribution to total IMR are 0.21, 0.89, and 0.26 per 1000 live births (P < 0.0001). Modified IMRs are 4.98, 10.85, and 4.69 deaths per 1000 live births.
CONCLUSION
IMR standardization with a minimum GA may obscure the disproportionate contribution of previable births to IMRs among the black population, which has the largest proportion of previable births.
目的
量化美国（US）婴儿死亡率（IMR）中，各种族间早产活产儿（<20 周妊娠龄（GA））的贡献差异。
方法
本研究采用 CDC WONDER 数据库，基于美国活产儿（2007-14 年）的人群回顾性队列研究，按照产妇种族/族裔进行分层。我们比较了早产活产儿对 IMR 的贡献，并计算了每个组中排除早产活产儿后的改良 IMR（≥20 周 GA）。使用列联表和卡方检验来检测组间差异。
结果
非西班牙裔白人、非西班牙裔黑人和西班牙裔的早产死亡分别占总死亡的 4.1%、7.7%和 5.0%。早产对总 IMR 的贡献分别为每 1000 例活产儿 0.21、0.89 和 0.26（P<0.0001）。改良 IMR 分别为每 1000 例活产儿 4.98、10.85 和 4.69 例死亡。
结论
采用最小 GA 进行 IMR 标准化可能会掩盖黑人中早产活产儿对 IMR 不成比例的贡献，而黑人的早产活产儿比例最大。
Zotero 插件