Haglund B, Cnattingius S, Nordström M L
Centre for Primary Care Research, Uppsala University Hospital, Sweden.
Paediatr Perinat Epidemiol. 1993 Jan;7(1):33-44. doi: 10.1111/j.1365-3016.1993.tb00599.x.
Social differences in late fetal death and infant mortality were examined in a population-based prospective study. All singletons born to Nordic citizens in Sweden 1985-86 were included, 185,156 births in all. The overall rates of late fetal death and infant mortality were 3.5 and 5.3 per 1000 respectively. Socio-economic status of the household (SES) and mothers' education were used as social indicators. Logistic regression analyses showed significant odds ratios between 1.3 and 1.8 for late fetal death for blue-collar workers and women with less than 12 years education. The analyses of neonatal mortality showed a U-shaped relationship: both unskilled blue-collar workers and high level white-collar workers had significant odds ratios (OR) as compared with intermediate level white-collar workers (OR = 1.5). Similar results were obtained when using the mothers' education as indicator of social status: 9 years education or less or 15 years or more were associated with significant higher mortality rates than 12 years education (OR = 1.6). An inverse relationship between social status and post-neonatal mortality was seen in the crude analysis. Mothers' education revealed more social differences than SES (crude OR = 2.0 and 1.5 respectively in the least privileged group). However, when adjusting for the effects of maternal age, parity and smoking, no significant odds ratios for the social variables were obtained.
在一项基于人群的前瞻性研究中,对死产和婴儿死亡率方面的社会差异进行了调查。纳入了1985 - 1986年在瑞典出生的所有北欧公民单胎婴儿,共计185,156例出生。死产和婴儿死亡率的总体发生率分别为每1000例3.5例和5.3例。家庭社会经济地位(SES)和母亲受教育程度被用作社会指标。逻辑回归分析显示,蓝领工人和受教育年限不足12年的女性死产的优势比在1.3至1.8之间,具有显著差异。新生儿死亡率分析呈现出U型关系:与中级白领工人相比,非熟练蓝领工人和高级白领工人的优势比均具有显著性(优势比 = 1.5)。以母亲受教育程度作为社会地位指标时,也得到了类似结果:受教育9年及以下或15年及以上的人群,其死亡率显著高于受教育12年的人群(优势比 = 1.6)。在粗分析中,观察到社会地位与新生儿后期死亡率呈负相关。母亲受教育程度所显示的社会差异比社会经济地位更大(在最弱势人群中,粗优势比分别为2.0和1.5)。然而,在对母亲年龄、产次和吸烟的影响进行校正后,未获得社会变量的显著优势比。