Forbes J F, Boddy F A, Pickering R, Wyllie M M
J Epidemiol Community Health. 1982 Dec;36(4):282-8. doi: 10.1136/jech.36.4.282.
An examination of the recent decline in perinatal mortality in Scotland during the 1970s showed that despite substantial changes in fertility and the demographic pattern of births, differences in the age, parity, and social class composition of the obstetric population in this decade accounted for just 7% of the overall improvement in perinatal mortality between 1970 and 1979. The general pattern of relative risks associated with maternal age, parity, and social class remained largely unchanged. Marginal changes in the birthweight distribution, however, were sufficient to account for 13% of the reduction in perinatal mortality. The low birthweight infant, especially those weighing under 1500 g, assumed increasing importance as a factor in perinatal mortality owing to a progressive worsening in the relative risk of perinatal mortality associated with low birth weight. Although regional differences in perinatal mortality persisted over this period, there occurred some lessening of the traditional inequality between western and eastern parts of the country. Finally, registered causes of perinatal mortality are reviewed. In the absence of other explanations the results of this analysis, collectively, suggest that much of the recent decline in perinatal mortality was perhaps due to changes in obstetric practice and in the clinical management of neonatal morbidity.
对20世纪70年代苏格兰围产期死亡率近期下降情况的一项调查显示，尽管生育情况和出生人口的人口结构发生了重大变化，但这十年间产科人群在年龄、胎次和社会阶层构成方面的差异，仅占1970年至1979年围产期死亡率总体改善情况的7%。与产妇年龄、胎次和社会阶层相关的相对风险总体模式基本保持不变。然而，出生体重分布的微小变化足以解释围产期死亡率降低的13%。低体重婴儿，尤其是体重不足1500克的婴儿，由于低体重相关围产期死亡率的相对风险不断恶化，作为围产期死亡的一个因素变得越来越重要。尽管这一时期围产期死亡率存在地区差异，但该国西部和东部之间传统的不平等现象有所减轻。最后，对围产期死亡的登记原因进行了回顾。在没有其他解释的情况下，综合这项分析的结果表明，近期围产期死亡率的下降很大程度上可能归因于产科实践和新生儿疾病临床管理的变化。
