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母亲年龄对极低出生体重单胎婴儿新生儿结局的影响:一项基于人群的研究。

Effect of maternal age on neonatal outcomes in very low birth weight singleton infants: a population-based study.

作者信息

Kasirer Yair, Bin Nun Alona, Bental Yoram A, Reichman Brian, Zaslavsky-Paltiel Inna, Lerner-Geva Liat, Mimouni Francis B

机构信息

Department of Neonatology, the Shaare Zedek Medical center, Jerusalem, Israel.

Department of Pediatrics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

J Perinatol. 2023 Apr;43(4):424-429. doi: 10.1038/s41372-023-01620-9. Epub 2023 Feb 4.

Abstract

BACKGROUND

Little is known on the impact of maternal age (MA) on very low birth weight (VLBW) infants' outcomes. We tested the hypothesis that at both ends of MA there are increased adverse neonatal outcomes in VLBW infants.

METHODS

We used the Israel National Neonatal Network VLBW (≤1500 g) database. Maternal age was stratified as: <20, 20-24, 25-34 (reference group), 35-39 and ≥40 years. Statistical analyses were univariate and multivariable logistic regression analysis.

RESULTS

After adjustment, the infant outcomes of older mothers were similar to those of the reference group for mortality, RDS, severe ROP, NEC and sepsis. Mothers < 20 and 20-24 years old had higher odds of IVH grades 3-4 (OR 1.45, 95% CI 1.09-1.93 and OR 1.26, 95% CI 1.10-1.45, respectively), and BPD (OR 1.55, 95% CI 1.13-2.13 and OR 1.40, 95% CI 1.22-1.62, respectively). There were higher odds for PVL in infants of <20 year-old mothers (OR 1.83, 95% CI 1.26-2.65) and in infants of 35-39 year-old mothers (OR 1.38, 95% CI 1.12-1.69). Poor composite outcomes were significantly higher in the youngest maternal age categories (<20-year-old mothers (OR 1.63, 95% CI 1.28-2.08), and 20-24-year-old (OR 1.28, 95% CI 1.15-1.43).

CONCLUSIONS

Neonatal outcomes differ in relation to maternal age among very low birth weight newborns, with adverse outcomes more predominant in infants of younger mothers.

摘要

背景

关于母亲年龄(MA)对极低出生体重(VLBW)婴儿结局的影响,人们了解甚少。我们检验了这样一个假设,即在MA的两端,VLBW婴儿的不良新生儿结局会增加。

方法

我们使用了以色列国家新生儿网络极低出生体重(≤1500克)数据库。母亲年龄分层如下:<20岁、20 - 24岁、25 - 34岁(参照组)、35 - 39岁和≥40岁。统计分析采用单变量和多变量逻辑回归分析。

结果

调整后,年龄较大母亲的婴儿在死亡率、呼吸窘迫综合征(RDS)、重度视网膜病变(ROP)、坏死性小肠结肠炎(NEC)和败血症方面的结局与参照组相似。年龄<20岁和20 - 24岁的母亲所生婴儿发生3 - 4级脑室内出血(IVH)的几率更高(分别为OR 1.45,95%可信区间[CI] 1.09 - 1.93和OR 1.26,95% CI 1.10 - 1.45),以及发生支气管肺发育不良(BPD)的几率更高(分别为OR 1.55,95% CI 1.13 - 2.13和OR 1.40,95% CI 1.22 - 1.62)。<20岁母亲所生婴儿以及35 - 39岁母亲所生婴儿发生脑室周围白质软化(PVL)的几率更高(分别为OR 1.83,95% CI 1.26 - 2.65和OR 1.38,95% CI 1.12 - 1.69)。最年轻母亲年龄组(<20岁母亲(OR 1.63,95% CI 1.28 - 2.08)和20 - 24岁母亲(OR 1.28,95% CI 1.15 - 1.43))的不良综合结局显著更高。

结论

极低出生体重新生儿的新生儿结局因母亲年龄而异,不良结局在年轻母亲所生婴儿中更为常见。

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