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威尔士患有先天异常的婴儿住院的风险因素。

Risk factors for hospitalisation in Welsh infants with a congenital anomaly.

机构信息

National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

出版信息

BMJ Paediatr Open. 2022 Feb;6(1). doi: 10.1136/bmjpo-2021-001238.

Abstract

OBJECTIVES

To investigate risk factor associated with hospitalisation of infants with a congenital anomaly in Wales, UK.

DESIGN

A population-based cohort study.

SETTING

Data from the Welsh Congenital Anomaly Register and Information Service linked to the Patient Episode Database for Wales and livebirths and deaths from the Office for National Statistics.

PATIENTS

All livebirths between 1999 and 2015 with a diagnosis of a congenital anomaly, which was defined as a structural, metabolic, endocrine or genetic defect, as well as rare diseases of hereditary origin.

MAIN OUTCOME MEASURES

Adjusted OR (aOR) associated with 1 or 2+ hospital admissions in infancy versus no admissions were estimated for sociodemographic, maternal and infant factors using multinomial logistic regression for the subgroups of all, isolated, multiple and cardiovascular anomalies.

RESULTS

25 523 infants affected by congenital anomalies experienced a total of 50 705 admissions in infancy. Risk factors for ≥2 admissions were younger maternal age ≤24 years (aOR: 1.17; 95% CI 1.06 to 1.30), maternal smoking (aOR: 1.20; 1.10 to 1.31), preterm birth (aOR: 2.52; 2.25 to 2.83) and moderately severe congenital heart defects (aOR: 6.25; 4.47 to 8.74). Girls had an overall decreased risk of 2+ admissions (aOR: 0.84; 0.78 to 0.91). Preterm birth was a significant risk factor for admissions in all anomaly subgroups but the effect of the other characteristics varied according to anomaly subgroup.

CONCLUSIONS

Over two-thirds of infants with an anomaly are admitted to hospital during infancy. Our findings identified sociodemographic and clinical characteristics contributing to an increased risk of hospitalisation of infants with congenital anomalies.

摘要

目的

调查英国威尔士先天性异常婴儿住院的相关危险因素。

设计

基于人群的队列研究。

设置

数据来自威尔士先天性异常登记和信息服务处,与威尔士患者住院数据库以及来自国家统计局的活产和死亡记录相关联。

患者

1999 年至 2015 年间所有患有先天性异常的活产儿,该疾病定义为结构、代谢、内分泌或遗传缺陷,以及具有遗传来源的罕见遗传性疾病。

主要观察指标

使用多项逻辑回归对所有、孤立性、多发性和心血管异常亚组,针对社会人口统计学、产妇和婴儿因素,估计与婴儿期 1 次或 2 次以上住院相关的调整比值比(aOR)。

结果

25523 名患有先天性异常的婴儿共经历了 50705 次婴儿期住院。≥2 次住院的危险因素包括产妇年龄≤24 岁(aOR:1.17;95%CI:1.06 至 1.30)、母亲吸烟(aOR:1.20;1.10 至 1.31)、早产(aOR:2.52;2.25 至 2.83)和中度严重先天性心脏病(aOR:6.25;4.47 至 8.74)。女孩总体上 2 次以上住院的风险降低(aOR:0.84;0.78 至 0.91)。早产是所有异常亚组住院的一个重要危险因素,但其他特征的影响因异常亚组而异。

结论

超过三分之二的患有异常的婴儿在婴儿期住院。我们的研究结果确定了导致患有先天性异常的婴儿住院风险增加的社会人口统计学和临床特征。

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