Wu Bohao, Taylor Sarah, Shabanova Veronika, Hawley Nicola L
Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, United States of America.
Division of Neonatal-Perinatal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America.
PLoS One. 2024 Dec 31;19(12):e0316048. doi: 10.1371/journal.pone.0316048. eCollection 2024.
Predicting neonatal survival is essential for targeting interventions to reduce neonatal mortality. Pacific Islanders have been underrepresented in existing prediction tools and have unique, maternal obesity-related risk factors for both preterm birth and neonatal mortality. Using neonatal sex, birth weight, and gestational age, we developed a graphical tool for neonatal survival among Pacific Islander singletons in the United States.
Birth-infant death data files from the United States National Center for Health Statistics were used (2014-2018). Pacific Islander mothers and singletons without congenital anomalies born between 22-36 gestational weeks were included. Poisson regression models were used to predict neonatal mortality (<28 days of life) rate including neonatal sex, birth weight, and gestational age in weeks as predictors. Predicted survival rates in the graphical tool were calculated as "1 minus mortality rate".
Of the 5192 included neonates, the neonatal mortality rate was 2.0%; 43.5% of mothers had pre-pregnancy obesity, and 16.5% of neonates were born large-for-gestational age. Birth weight and gestational age had a non-linear association with neonatal death, and their interaction was included in the model. Retaining neonatal sex, models with gestational age at birth or both birth weight and gestational age at birth performed better than the model with birth weight only.
This is the first graphical tool for neonatal survival prediction among preterm-born Pacific Islander singletons in the United States. Using only neonatal sex, birth weight, and gestational age, this graphical tool is a straightforward reference for survival among groups of neonates with similar characteristics.
预测新生儿存活率对于确定降低新生儿死亡率的干预措施至关重要。在现有的预测工具中，太平洋岛民的代表性不足，并且他们存在与母亲肥胖相关的早产和新生儿死亡的独特风险因素。我们利用新生儿性别、出生体重和胎龄，开发了一种用于预测美国太平洋岛民单胎新生儿存活率的图形工具。
使用了美国国家卫生统计中心的出生-婴儿死亡数据文件（2014 - 2018年）。纳入了孕周在22 - 36周之间出生、无先天性异常的太平洋岛民母亲及其单胎新生儿。采用泊松回归模型预测新生儿死亡率（出生后<28天），将新生儿性别、出生体重和以周为单位的胎龄作为预测因素。图形工具中的预测存活率计算为“1减去死亡率”。
在纳入的5192例新生儿中，新生儿死亡率为2.0%；43.5%的母亲孕前肥胖，16.5%的新生儿为大于胎龄儿。出生体重和胎龄与新生儿死亡呈非线性关联，且其相互作用被纳入模型。保留新生儿性别，包含出生时胎龄或同时包含出生体重和出生时胎龄的模型比仅包含出生体重的模型表现更好。
这是美国首个用于预测早产太平洋岛民单胎新生儿存活率的图形工具。仅使用新生儿性别、出生体重和胎龄，该图形工具是具有相似特征的新生儿群体存活率的直接参考。
