Stoll B J, Holman R C, Schuchat A
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30335, USA.
Pediatrics. 1998 Aug;102(2):e18. doi: 10.1542/peds.102.2.e18.
Infant mortality in the United States has continued to decline in recent years, but changes in sepsis-associated deaths among infants have not been evaluated previously.
Data from US death records were analyzed for the period 1979 through 1994 to assess trends in sepsis-associated deaths among newborns and older infants.
Annual neonatal mortality associated with sepsis declined by 25% from 50.5 deaths per 100 000 live births in 1979 through 1981 to 38.0 deaths per 100 000 live births in 1992 through 1994. Although infant mortality associated with sepsis declined from 71.7 to 56.4 per 100 000 live births over the same period, this decline was attributable to lower sepsis-related mortality among newborns. The rates of sepsis-associated deaths declined for both preterm and term deliveries. Approximately 2260 infants (1521 of whom were newborns) died of sepsis per year in 1992 through 1994. Sepsis-associated death was more likely to occur among infants who were male, black, preterm, or born in the South. Among black infants, the racial gap in sepsis-associated mortality was greater for term than for preterm infants.
Despite declines in the overall sepsis-related mortality among newborns, racial and regional gaps in mortality persisted over the 16-year study period. Almost half of the sepsis-related deaths occurred among infants who were born prematurely. Disproportionate rates of prematurity among blacks and infants born in the South may have contributed to persistently high sepsis-related mortality in these groups. Future efforts to reduce the incidence of sepsis-associated deaths will depend on targeting higher risk populations and reducing prematurity.
近年来，美国婴儿死亡率持续下降，但此前尚未评估婴儿中与败血症相关的死亡情况变化。
分析了1979年至1994年期间美国死亡记录的数据，以评估新生儿和大龄婴儿中与败血症相关的死亡趋势。
与败血症相关的年度新生儿死亡率从1979年至1981年每10万例活产50.5例死亡下降了25%，至1992年至1994年每10万例活产38.0例死亡。尽管同期与败血症相关的婴儿死亡率从每10万例活产71.7例降至56.4例，但这一下降归因于新生儿中败血症相关死亡率的降低。早产和足月分娩的败血症相关死亡率均有所下降。1992年至1994年期间，每年约有2260名婴儿（其中1521名是新生儿）死于败血症。败血症相关死亡更有可能发生在男性、黑人、早产或在南方出生的婴儿中。在黑人婴儿中，足月婴儿败血症相关死亡率的种族差距大于早产婴儿。
尽管新生儿中与败血症相关的总体死亡率有所下降，但在16年的研究期间，死亡率的种族和地区差距仍然存在。几乎一半的败血症相关死亡发生在早产儿中。黑人以及南方出生的婴儿中早产率过高可能导致了这些群体中败血症相关死亡率持续居高不下。未来降低败血症相关死亡发生率的努力将取决于针对高危人群并减少早产情况。
