2003-2016 年澳大利亚新南威尔士州按产妇出生地和胎龄划分的新生儿发病率。

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003-2016.

机构信息

Women and Babies Research, The University of Sydney Northern Clinical School, St Leonards, NSW, Australia.

NSW Biostatistics Training Program, NSW Ministry of Health, Sydney, NSW, Australia.

出版信息

Acta Obstet Gynecol Scand. 2021 Feb;100(2):331-338. doi: 10.1111/aogs.14012. Epub 2020 Oct 22.

DOI:10.1111/aogs.14012

PMID:33007108

Abstract

INTRODUCTION

Research suggests that neonatal morbidity differs by maternal region of birth at different gestational ages. This study aimed to determine the overall and gestation-specific risk of neonatal morbidity by maternal region of birth, after adjustment for maternal, infant and birth characteristics, for women giving birth in New South Wales, Australia, from 2003 to 2016.

MATERIAL AND METHODS

The study utilized a retrospective cohort study design using linked births, hospital and deaths data. Modified Poisson regression was used to determine risk with 95% confidence intervals (95% CI) of neonatal morbidity by maternal region of birth, overall and at each gestational age, compared with Australian or New Zealand-born women giving birth at 39 weeks.

RESULTS

There were 1 074 930 live singleton births ≥32 weeks' gestation that met the study inclusion criteria, and 44 394 of these were classified as morbid, giving a neonatal morbidity rate of 4.13 per 100 live births. The gestational age-specific neonatal morbidity rate declined from 32 weeks' gestation, reaching a minimum at 39 weeks in all maternal regions of birth. The unadjusted neonatal morbidity rate was highest in South Asian-born women at most gestations. Adjusted rates of neonatal morbidity between 32 and 44 weeks were significantly lower for babies born to East (adjusted relative risk [aRR] 0.65, 95% CI 0.62-0.68), South-east (aRR 0.76, 95% CI 0.73-0.79) and West Asian-born (aRR 0.93, 95% CI 0.88-0.98) mothers, and higher for babies of Oceanian-born (aRR 1.11, 95% CI 1.04-1.18) mothers, compared with Australian or New Zealand-born mothers. Babies of African, Oceanian, South Asian and West Asian-born women had a lower adjusted risk of neonatal morbidity than Australian or New Zealand-born women until 37 or 38 weeks' gestation, and thereafter an equal or higher risk in the term and post-term periods.

CONCLUSIONS

Maternal region of birth is an independent risk factor for neonatal morbidity in New South Wales.

摘要

引言

研究表明，新生儿发病率因产妇的出生地区而异，且在不同的孕龄有所不同。本研究旨在确定澳大利亚新南威尔士州的产妇在不同孕龄时，通过产妇出生地区来确定整体和特定孕龄的新生儿发病率的风险，同时调整了产妇、婴儿和分娩的特征。

材料和方法

本研究使用了回顾性队列研究设计，利用了出生、住院和死亡数据进行研究。采用修正泊松回归，通过产妇的出生地区与澳大利亚或新西兰出生、在 39 周时分娩的女性进行比较，确定了整体和每个孕龄的新生儿发病率的风险，同时给出了 95%置信区间（95%CI）。

结果

共有 1074930 例满足研究纳入标准的≥32 周单胎活产儿，其中 44394 例为病态新生儿，发病率为每 100 例活产儿 4.13 例。所有产妇出生地区的胎龄特异性新生儿发病率从 32 周开始下降，在 39 周达到最低。在大多数孕龄中，南亚出生的女性未调整的新生儿发病率最高。在 32 周至 44 周之间，东亚（调整后相对风险 [aRR] 0.65，95%CI 0.62-0.68）、东南亚（aRR 0.76，95%CI 0.73-0.79）和西亚（aRR 0.93，95%CI 0.88-0.98）出生的母亲所生婴儿的新生儿发病率调整率显著降低，而大洋洲（aRR 1.11，95%CI 1.04-1.18）出生的母亲所生婴儿的发病率调整率更高。与澳大利亚或新西兰出生的母亲相比，非洲、大洋洲、南亚和西亚出生的母亲所生婴儿的新生儿发病率在 37 或 38 周之前较低，而在足月和过期期间则处于同等或更高的风险。