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美国低出生体重的流行情况和风险因素:对 2016-2021 年数据的分析。

Prevalence and risk factors of low birth weight in the United States: An analysis of 2016-2021 data.

机构信息

Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA.

Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA.

出版信息

Am J Hum Biol. 2024 Apr;36(4):e24016. doi: 10.1002/ajhb.24016. Epub 2023 Nov 16.

Abstract

BACKGROUND

Low birthweight (LBW), infants weighing less than 2,500 g, is a global health concern associated with high infant morbidity and mortality rates. This study investigates LBW prevalence and its relation to maternal sociodemographic characteristics and lifestyle behaviors factors in the United States (US).

METHODS

This analysis used the National Survey of Children's Health (NSCH) data from 2016 to 2021, including n = 225,443 children aged 0-17 years. 18,131 had LBW (<2,500 g), and 2810 had very LBW (VLBW) (<1,500 g). Logistic regression calculated odds ratios (OR) using LBW as the dependent variable, adjusting for various factors.

RESULTS

Between 2016 and 2021 in the United States, LBW prevalence averaged 9.31%, with VLBW at 1.50%. Mothers aged 18-35, White, had the lowest LBW (7.63%) and VLBW (1.17%) rates. Mothers aged ≤18 years, black, had the highest LBW (15.45%) and VLBW infants (4.70%). Maternal age emerged as a significant LBW factor, with an OR of 1.27 for ≤18 and 1.19 for >35. Children in poor health had the highest OR (2.87). Race/ethnicity and other disparities were observed.

CONCLUSION

Our study highlights LBW risk among non-White mothers with specific criteria, emphasizing the need for continued exploration of intersectional targets for change that are exacerbating LBW disparities among marginalized populations which may be artificially attributed to biologic determinants and individual-level risk factors. In-depth analysis of repressive structures at the root of inequalities demand continued research on macro levels of influence. Customized healthcare reform holds the greatest potential to disrupt the patterns contributing to poor health outcomes among LBW children, and will ultimately maximize the reach and effectiveness of health promotion strategies and clinical practices aimed to improve universal maternal and infant health.

摘要

背景

低出生体重(LBW)是指婴儿体重低于 2500 克,这是一个全球性的健康问题,与高婴儿发病率和死亡率有关。本研究调查了美国 LBW 的流行情况及其与产妇社会人口特征和生活方式行为因素的关系。

方法

本分析使用了 2016 年至 2021 年的全国儿童健康调查(NSCH)数据,包括 n=225443 名 0-17 岁的儿童。其中 18131 例为 LBW(<2500 克),2810 例为极低出生体重(VLBW)(<1500 克)。使用 LBW 作为因变量的逻辑回归计算了优势比(OR),并调整了各种因素。

结果

2016 年至 2021 年,美国 LBW 的流行率平均为 9.31%,VLBW 为 1.50%。年龄在 18-35 岁之间的白人母亲的 LBW(7.63%)和 VLBW(1.17%)发生率最低。年龄在 18 岁以下的黑人母亲的 LBW(15.45%)和 VLBW 婴儿(4.70%)发生率最高。产妇年龄是 LBW 的一个重要因素,≤18 岁的 OR 为 1.27,>35 岁的 OR 为 1.19。健康状况较差的儿童的 OR 最高(2.87)。观察到种族/民族和其他差异。

结论

本研究强调了具有特定标准的非白人母亲的 LBW 风险,强调需要继续探索加剧边缘化人群 LBW 差异的交叉目标,这些差异可能被人为归因于生物决定因素和个体风险因素。对不平等根源的压抑结构的深入分析需要继续研究宏观层面的影响。定制医疗改革最有可能打破导致 LBW 儿童健康状况不佳的模式,并最终最大限度地扩大和提高旨在改善普遍母婴健康的健康促进战略和临床实践的效果。

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