加利福尼亚州极低出生体重儿产后生长的种族和民族差异。
Racial and ethnic disparities in postnatal growth among very low birth weight infants in California.
机构信息
Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.
California Perinatal Quality Care Collaborative, Stanford, CA, USA.
出版信息
J Perinatol. 2023 Mar;43(3):371-377. doi: 10.1038/s41372-023-01612-9. Epub 2023 Feb 3.
OBJECTIVE
To identify racial/ethnic disparities in postnatal growth by year and gestational age among very low birth weight infants.
STUDY DESIGN
Total 37,122 infants, with birth weight 500-1500 g or gestational age 23-34 weeks in the California Perinatal Quality Care Collaborative in 2008-2016. Postnatal growth failure (PGF) was defined as change in weight Z-score from birth to discharge below -1.28. Multivariable regression analysis with birth hospital as random effect was used to estimate odds ratios (OR).
RESULTS
Infants born to Hispanic mothers had highest risk of PGF at 30%, compared to white (24%, OR 1.33), Black (22%, OR 1.50), or Asian/Pacific Islander mothers (23%, OR 1.38). PGF incidence decreased from 2008 (27.4%) to 2016 (22.8%) with differences in trends by race. Each increasing gestational age week was associated with decreasing risk for PGF (OR 0.73, 95% confidence interval 0.72-0.74).
CONCLUSION
Targeted interventions addressing PGF are needed to address disparities.
目的
在加利福尼亚围产期质量协作组（California Perinatal Quality Care Collaborative）2008-2016 年出生体重 500-1500g 或胎龄 23-34 周的极低出生体重儿中，按年和胎龄分析种族/民族间产后生长迟缓的差异。
研究设计
共有 37122 名婴儿符合研究标准，出生体重 500-1500g 或胎龄 23-34 周，来自加利福尼亚围产期质量协作组，在 2008-2016 年期间出生。产后生长迟缓（PGF）定义为出生至出院时体重 Z 评分下降超过 -1.28。采用以出生医院为随机效应的多变量回归分析来估计比值比（OR）。
结果
与白人（24%，OR 1.33）、黑人（22%，OR 1.50）或亚裔/太平洋岛民（23%，OR 1.38）母亲相比，西班牙裔母亲所生婴儿发生 PGF 的风险最高，达 30%。PGF 的发生率从 2008 年（27.4%）下降到 2016 年（22.8%），不同种族的趋势存在差异。胎龄每增加一周，发生 PGF 的风险就会降低（OR 0.73，95%置信区间 0.72-0.74）。
结论
需要针对 PGF 采取有针对性的干预措施来解决差异问题。
Zotero 插件