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早产与子代的长期小儿眼科疾病

Early-term deliveries and long-term pediatric ophthalmic morbidity of the offspring.

作者信息

Ben-Shmuel Atar, Sheiner Eyal, Tsumi Erez, Wainstock Tamar, Feinblum Dvora, Walfisch Asnat

机构信息

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Int J Gynaecol Obstet. 2022 Jun;157(3):640-646. doi: 10.1002/ijgo.13875. Epub 2021 Aug 30.

Abstract

OBJECTIVE

To examine whether early-term delivery impacts on the long-term ophthalmic health of offspring.

METHODS

A retrospective population-based cohort study was conducted, including all singleton deliveries (1991-2014) occurring at a tertiary medical center. Gestational age was divided into: early prematurity, late prematurity, and early, full, late, and post term. Hospitalizations of offspring up to 18 years of age involving ophthalmic morbidity were evaluated. Survival curves compared cumulative hospitalizations and regression models controlled for confounders.

RESULTS

During the study period, 243 363 deliveries met the inclusion criteria. Ophthalmic-related hospitalization rates were lower among early-term born children (1.0%) as compared with early- (2.2%) and late-preterm (1.3%) born children, but higher than those in full- (0.9%), late- (0.8%), and post-term (0.8%) born offspring (P < 0.001). The survival curve demonstrated significantly different hospitalization rates in the different gestational ages (P < 0.001). The regression demonstrated an independent risk for ophthalmic morbidity among early-term born offspring (adjusted hazard ratio 1.14, confidence interval 1.03-1.27, P = 0.009), whereas late- and post-term deliveries were associated with a lower risk (adjusted hazard ratio 0.83 and 0.74, respectively) as compared with full-term deliveries.

CONCLUSION

The risk for long-term ophthalmic-related hospitalizations of offspring gradually declines as gestational age advances.

摘要

目的

研究早产对后代长期眼部健康的影响。

方法

开展一项基于人群的回顾性队列研究,纳入一家三级医疗中心在1991年至2014年期间发生的所有单胎分娩病例。将孕周分为:极早早产、晚期早产、早期足月、足月、晚期足月和过期妊娠。对18岁以下后代因眼科疾病的住院情况进行评估。生存曲线比较累积住院率,回归模型对混杂因素进行控制。

结果

在研究期间,243363例分娩符合纳入标准。与极早早产(2.2%)和晚期早产(1.3%)出生的儿童相比,早期足月出生儿童的眼科相关住院率较低(1.0%),但高于足月(0.9%)、晚期足月(0.8%)和过期妊娠(0.8%)出生的后代(P<0.001)。生存曲线显示不同孕周的住院率存在显著差异(P<0.001)。回归分析表明,早期足月出生的后代患眼科疾病有独立风险(调整后的风险比为1.14,置信区间为1.03-1.27,P=0.009),而与足月分娩相比,晚期足月和过期妊娠分娩的风险较低(调整后的风险比分别为0.83和0.74)。

结论

随着孕周增加,后代长期眼科相关住院风险逐渐降低。

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