Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.
Department of History, University of Zurich, Zurich, Switzerland.
PLoS One. 2023 Aug 16;18(8):e0289157. doi: 10.1371/journal.pone.0289157. eCollection 2023.
The identification of factors impeding normal fetal development and growth is crucial for improving neonatal health. Historical studies are relevant because they show which parameters have influenced neonatal health in the past in order to better understand the present. We studied temporal changes of neonatal health outcomes (birth weight, gestational age, stillbirth rate) and the influence of different cofactors in two time periods. Moreover, we investigated particularly neonatal health in the wake of the 1918/19 influenza pandemic. Data were transcribed from the Bern Maternity Hospital and consists of two time periods: A) The years 1880, 1885, 1890, 1895 and 1900 (N = 1530, births' coverage 20%); B) The years 1914-1922 (N = 6924, births' coverage 40-50%). Linear regression models were used to estimate the effect of birth year on birth weight, and logistic regression models to estimate the effect of birth year and of the exposure to the pandemic on premature birth, stillborn and low birth weight (LBW). Mean birth weight increased only minimally between the two datasets; whereas, in the years 1914-1922, the preterm birth and stillbirth rates were markedly reduced compared with the years 1880-1900. Sex, parity, gestational age and maternal age were significantly associated with birth weight in both time periods. The probability of LBW was significantly increased in 1918 (OR 1.49 (95% CI 1.00-2.23)) and in 1919 (OR 1.55 (95% CI 1.02-2.36)) compared to 1914. Mothers who were heavily exposed to the influenza pandemic during pregnancy had a higher risk of stillbirth (OR 2.27 (95% CI 1.32-3.9)). This study demonstrated that factors influencing neonatal health are multifactorial but similar in both time periods. Moreover, the exposure to the 1918/19 pandemic was less associated with LBW and more associated with an increased risk of stillbirth. If this trend is confirmed by further studies, it could indicate some consistency across pandemics, as similar patterns have recently been shown for COVID-19.
确定阻碍胎儿正常发育和生长的因素对于改善新生儿健康至关重要。历史研究具有相关性，因为它们可以显示过去哪些参数影响了新生儿健康，以便更好地了解现在。我们研究了两个时期新生儿健康结果（出生体重、胎龄、死产率）的时间变化以及不同协变量的影响。此外，我们还特别研究了 1918/19 流感大流行后的新生儿健康状况。数据是从伯尔尼妇产医院转录的，包括两个时期：A）1880 年、1885 年、1890 年、1895 年和 1900 年（N=1530，出生覆盖率 20%）；B）1914-1922 年（N=6924，出生覆盖率 40-50%）。我们使用线性回归模型估计出生年份对出生体重的影响，使用逻辑回归模型估计出生年份和暴露于大流行对早产、死产和低出生体重（LBW）的影响。两个数据集之间出生体重仅略有增加；然而，1914-1922 年与 1880-1900 年相比，早产和死产率明显降低。在两个时期，性别、产次、胎龄和母亲年龄与出生体重显著相关。1918 年（OR 1.49（95%CI 1.00-2.23））和 1919 年（OR 1.55（95%CI 1.02-2.36））与 1914 年相比，LBW 的概率显著增加。母亲在怀孕期间大量接触流感大流行，死产的风险更高（OR 2.27（95%CI 1.32-3.9））。这项研究表明，影响新生儿健康的因素是多方面的，但在两个时期是相似的。此外，暴露于 1918/19 大流行与 LBW 的相关性较小，而与死产风险增加的相关性较大。如果进一步的研究证实了这一趋势，那么它可能表明大流行之间存在一些一致性，因为最近 COVID-19 也显示出类似的模式。
