Waldhoer T, Haidinger G, Langgassner J, Tuomilehto J
Department of Epidemiology, University of Vienna.
Wien Klin Wochenschr. 1996;108(20):643-8.
We assessed the risk of stillbirth in Austria during 1984-1993 in dependence of the variables maternal age, birth weight, year of birth and sex. All children born in Austria between 1984 and 1993 were included in the study (905,939 births). The risk of stillbirth was estimated by means of a logistic regression model. During the study period, stillbirths decreased significantly in Austria. Both birth weight and maternal age had a non-linear association with the risk of stillbirth. The lowest stillbirth rate was in the birth weight category of 3300-3899 grams (g). Of all stillbirths 62% occurred in infants weighing < or = 2500 g at birth. We also found a significant interaction between birth weight and year of birth suggesting that the effect of birth weight was not stable over the years. The proportion of young mothers (< 20 years) decreased clearly over the observation period. The proportion of low birth weight (< = or 2500 g) infants remained around 7.5% during the 10-year period, but the stillbirth rate decreased linearly over time in this group. In infants weighing > 2500 g at birth the stillbirth risk decreased during first five years but started to increase thereafter. Since over 60% of stillbirths in Austria occur in the low birth weight category, it is obvious that more effective strategies are needed for prevention of low birth weight births and fetal immaturity. In addition, further efforts are needed to prevent also high birth weight of newborns particularly in diabetic mothers.
我们评估了1984年至1993年期间奥地利死产的风险,该风险取决于产妇年龄、出生体重、出生年份和性别等变量。1984年至1993年在奥地利出生的所有儿童均纳入本研究(共905,939例出生)。通过逻辑回归模型估计死产风险。在研究期间,奥地利的死产率显著下降。出生体重和产妇年龄与死产风险均呈非线性关联。死产率最低的出生体重类别为3300 - 3899克。所有死产中,62%发生在出生体重≤2500克的婴儿中。我们还发现出生体重与出生年份之间存在显著交互作用,这表明出生体重的影响在多年间并不稳定。在观察期内,年轻母亲(<20岁)的比例明显下降。低出生体重(≤2500克)婴儿的比例在这10年期间保持在7.5%左右,但该组的死产率随时间呈线性下降。出生体重>2500克的婴儿,其死产风险在头五年下降,但此后开始上升。由于奥地利超过60%的死产发生在低出生体重类别中,显然需要更有效的策略来预防低出生体重儿出生和胎儿不成熟。此外,还需要进一步努力预防新生儿高出生体重,特别是糖尿病母亲所生婴儿的高出生体重。