Adams M M, Greenberg F, Khoury M J, Marks J S, Oakley G P
Am J Dis Child. 1985 May;139(5):518-23.
We studied the survival of a population-based cohort of 154 infants with spina bifida who were born during the eight-year period from 1972 through 1979 to residents of Atlanta. Our objectives were to describe the cohort's survival experience and to explore relationships between clinical characteristics and survival. Overall, 57% of the cohort survived one year or more. This figure is misleading, however, because it conceals important differences in survival among subgroups of affected infants. From univariate analyses, we observed significant differences in survival among infants categorized by year of birth, birth weight, the open-closed status of the defect, the highest level of the defect on the spine, the presence of multiple major birth defects, and the presence of hydrocephalus at birth. More infants born in the late 1970s survived their first year of life than infants born in the early 1970s; infants with open defects had lower survival than those with closed defects; and infants whose defects were low on the spine had better survival than those whose defects were higher. When comparing the survival experience of this cohort with that of other groups from other areas or from more recent years, health workers must consider referral biases and differences in the distribution of clinical characteristics.
我们研究了1972年至1979年这八年间出生于亚特兰大的154名脊柱裂婴儿的群体生存情况。我们的目标是描述该群体的生存经历，并探讨临床特征与生存之间的关系。总体而言，该群体中有57%的婴儿存活了一年或更长时间。然而，这个数字具有误导性，因为它掩盖了受影响婴儿亚组之间生存情况的重要差异。通过单变量分析，我们观察到按出生年份、出生体重、缺损的开放-闭合状态、脊柱上缺损的最高水平、是否存在多种主要出生缺陷以及出生时是否患有脑积水分类的婴儿在生存方面存在显著差异。20世纪70年代后期出生的婴儿比70年代早期出生的婴儿在一岁前存活的更多；开放性缺损的婴儿生存率低于闭合性缺损的婴儿；脊柱上缺损位置较低的婴儿生存率高于缺损位置较高的婴儿。在将该群体的生存经历与其他地区或近年来其他群体的生存经历进行比较时，卫生工作者必须考虑转诊偏差和临床特征分布的差异。
