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青少年怀孕:了解年龄和种族对结局的影响。

Adolescent pregnancy: understanding the impact of age and race on outcomes.

作者信息

DuPlessis H M, Bell R, Richards T

机构信息

RAND, Health Sciences Program, Santa Monica, California 90407-2138, USA.

出版信息

J Adolesc Health. 1997 Mar;20(3):187-97. doi: 10.1016/S1054-139X(96)00174-7.

Abstract

PURPOSE

To determine the independent effects of maternal age and race/ethnicity on poor pregnancy outcomes, with and without controlling for other factors.

METHODS

Logistic regression analysis of 54,447 linked birth, fetal death, and infant death certificates in California from 1980-87.

RESULTS

Women of young maternal age (10-13 years) are approximately 2.5 times more likely to have a low birthweight infant and 3.4 times more likely to have a preterm birth than women of "prime" childbearing age. African-American women are 1.7 times more likely to have a low birthweight infant, and 2 times more likely to have a preterm birth than their white and Hispanic counterparts. The association of infant death with maternal age and race/ethnicity is statistically significant in the unadjusted models, however, those associations disappear completely when birthweight and gestational age are considered. Interactions between maternal age and race/ethnicity explained very little of the variability for any of the outcomes.

CONCLUSIONS

Maternal age at delivery and race/ethnicity are independently and significantly associated with poor pregnancy outcomes such as low birthweight and premature births. However, young maternal age and race/ethnicity do not appear to interact in a manner that produces a differential effect on the birth outcomes assessed in this study. The incidence of infant mortality is unrelated to maternal age or race/ethnicity, after controlling for prematurity and low birthweight, underscoring the importance of intervention efforts aimed at their prevention.

摘要

目的

确定孕产妇年龄和种族/族裔对不良妊娠结局的独立影响,同时考虑是否控制其他因素。

方法

对1980 - 1987年加利福尼亚州54447份关联的出生、死胎和婴儿死亡证明进行逻辑回归分析。

结果

与处于“最佳”生育年龄的女性相比,孕产妇年龄较小(10 - 13岁)的女性生出低体重婴儿的可能性约高2.5倍,早产的可能性约高3.4倍。非裔美国女性生出低体重婴儿的可能性比白人及西班牙裔女性高1.7倍,早产的可能性高2倍。在未经调整的模型中,婴儿死亡与孕产妇年龄和种族/族裔之间的关联具有统计学意义,然而,当考虑出生体重和孕周时,这些关联完全消失。孕产妇年龄与种族/族裔之间的相互作用对任何结局的变异性解释都很少。

结论

分娩时的孕产妇年龄和种族/族裔与低体重和早产等不良妊娠结局独立且显著相关。然而,年轻的孕产妇年龄和种族/族裔似乎并未以对本研究评估的出生结局产生差异影响的方式相互作用。在控制早产和低体重后,婴儿死亡率与孕产妇年龄或种族/族裔无关,这突出了旨在预防这些情况的干预措施的重要性。

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