早产儿新生儿期和新生儿后期住院期间死亡的危险因素。

Risk factors for death during newborn and post-newborn hospitalizations among preterm infants.

机构信息

Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

出版信息

J Perinatol. 2022 Oct;42(10):1288-1293. doi: 10.1038/s41372-022-01363-z. Epub 2022 Mar 21.

DOI:10.1038/s41372-022-01363-z

PMID:35314759

Abstract

OBJECTIVES

To examine risk factors for mortality among preterm infants during newborn and subsequent hospitalizations, and whether they differ by race/ethnicity.

STUDY DESIGN

We conducted a cross-sectional analysis using the 2016 Kids Inpatient Database. Hospitalizations of preterm infants were categorized as "newborn" for birth admissions, and "post-newborn" for all others. Multivariate logistic regression was performed to calculate associations of mortality with sociodemographic factors.

RESULTS

Of 285915 hospitalizations, there were 7827 (2.7%) deaths. During newborn hospitalizations, adjusted OR (aOR) of death equaled 1.14 (95% CI 1.09-1.20) for males, 68.73 (61.91-76.30) for <29 weeks GA, and 0.81 (0.71-0.92) for transfer. Stratified by race/ethnicity, aOR was 0.69 (0.61-0.71) for Medicaid only among black infants. During post-newborn hospitalizations, death was associated with transfer (aOR 5.02, 3.31-7.61).

CONCLUSIONS

Risk factors for death differ by hospitalization types and race/ethnicity. Analysis by hospitalization types may identify risk factors that inform public health interventions for reducing infant mortality.

摘要

目的

探讨新生儿期和随后住院期间早产儿死亡的危险因素，并分析这些危险因素是否因种族/民族而异。

研究设计

我们使用 2016 年儿科住院患者数据库进行了一项横断面分析。早产儿的住院被分为“新生儿”（出生时入院）和“新生儿后”（其他所有住院）。采用多变量逻辑回归计算死亡率与社会人口统计学因素的相关性。

结果

在 285915 例住院中，有 7827 例（2.7%）死亡。在新生儿住院期间，男性死亡的调整比值比（aOR）为 1.14（95%CI 1.09-1.20），胎龄<29 周的 aOR 为 68.73（61.91-76.30），而转院的 aOR 为 0.81（0.71-0.92）。按种族/民族分层，只有黑人婴儿的医疗补助 aOR 为 0.69（0.61-0.71）。在新生儿后住院期间，死亡与转院有关（aOR 为 5.02，3.31-7.61）。