美国 2011-2015 年妊娠期间母体感染与后代突发意外婴儿死亡风险。

Maternal infections in pregnancy and the risk of sudden unexpected infant death in the offspring in the U.S., 2011-2015.

机构信息

Master of Science in Data Science, University of Washington, Seattle, Washington, United States of America.

AI for Good Lab, Microsoft, Redmond, Washington, United States of America.

出版信息

PLoS One. 2023 Apr 21;18(4):e0284614. doi: 10.1371/journal.pone.0284614. eCollection 2023.

DOI:10.1371/journal.pone.0284614

PMID:37083949

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10121007/

Abstract

BACKGROUND

Infection is thought to play a part in some infant deaths. Maternal infection in pregnancy has focused on chlamydia with some reports suggesting an association with sudden unexpected infant death (SUID).

OBJECTIVES

We hypothesized that maternal infections in pregnancy are associated with subsequent SUID in their offspring.

SETTING

All births in the United States, 2011-2015.

DATA SOURCE

Centers for Disease Control and Prevention (CDC) Birth Cohort Linked Birth-Infant Death Data Files.

STUDY DESIGN

Cohort study, although the data were analysed as a case control study. Cases were infants that died from SUID. Controls were randomly sampled infants that survived their first year of life; approximately 10 controls per SUID case.

EXPOSURES

Chlamydia, gonorrhea and hepatitis C.

RESULTS

There were 19,849,690 live births in the U.S. for the period 2011-2015. There were 37,143 infant deaths of which 17,398 were classified as SUID cases (a rate of 0.86/1000 live births). The proportion of the control mothers with chlamydia was 1.7%, gonorrhea 0.2% and hepatitis C was 0.3%. Chlamydia was present in 3.8% of mothers whose infants subsequently died of SUID compared with 1.7% of controls (unadjusted OR = 2.35, 95% CI = 2.15, 2.56; adjusted OR = 1.08, 95% CI = 0.98, 1.19). Gonorrhea was present in 0.7% of mothers of SUID cases compared with 0.2% of mothers of controls (OR = 3.09, (2.50, 3.79); aOR = 1.20(0.95, 1.49)) and hepatitis C was present in 1.3% of mothers of SUID cases compared with 0.3% of mothers of controls (OR = 4.69 (3.97, 5.52): aOR = 1.80 (1.50, 2.15)).

CONCLUSIONS

The marked attenuation of SUID risk after adjustment for a wide variety of socioeconomic and demographic factors suggests the small increase in the risk of SUID of the offspring of mothers with infection with hepatitis C in pregnancy is due to residual confounding.

摘要

背景

感染被认为与一些婴儿死亡有关。孕妇感染衣原体一直是研究的焦点，一些报告表明其与婴儿猝死综合征（SUDI）有关。

目的

我们假设孕妇感染与后代的 SUDI 有关。

设置

美国 2011-2015 年所有分娩。

数据来源

疾病控制和预防中心（CDC）出生队列链接出生-婴儿死亡数据文件。

研究设计

队列研究，尽管数据被分析为病例对照研究。病例为死于 SUDI 的婴儿。对照组为存活至一岁的随机抽样婴儿；每个 SUID 病例约有 10 名对照。

暴露因素

衣原体、淋病和丙型肝炎。

结果

2011-2015 年期间，美国有 19849690 例活产。37143 例婴儿死亡，其中 17398 例被归类为 SUID 病例（活产 0.86/1000）。患有衣原体的对照组母亲比例为 1.7%，淋病为 0.2%，丙型肝炎为 0.3%。随后死于 SUID 的婴儿的母亲中，衣原体的比例为 3.8%，而对照组为 1.7%（未调整的 OR = 2.35，95%CI = 2.15，2.56；调整的 OR = 1.08，95%CI = 0.98，1.19）。淋病在 SUID 病例的母亲中为 0.7%，而对照组的母亲为 0.2%（OR = 3.09，（2.50，3.79）；aOR = 1.20（0.95，1.49）），丙型肝炎在 SUID 病例的母亲中为 1.3%，而对照组的母亲为 0.3%（OR = 4.69（3.97，5.52）：aOR = 1.80（1.50，2.15））。