Koupilová I, Bobák M, Holĉík J, Pikhart H, Leon D A
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, England.
Am J Public Health. 1998 Sep;88(9):1343-7. doi: 10.2105/ajph.88.9.1343.
This study investigated social variation in birth outcome in the Czech Republic after the political changes of 1989.
Routinely collected records on singleton live births in 1989, 1990, and 1991 (n = 380,633) and 1994, 1995, and 1996 (n = 286,907) were individually linked to death records.
Mean birthweight fell from 3,323 g to 3,292 g (P < .001) between 1989 and 1991 and then increased to 3,353 g by 1996. The gap in mean birthweight between mothers with a primary education and those with a university education, adjusted for age, parity, and sex of infants, widened from 182 g (95% confidence interval [CI] = 169, 19) in 1989 to 256 g (95% CI = 240, 272) in 1996. Similar trends were found for preterm births. Postneonatal mortality declined most among the better educated and the married. The odds ratio for postneonatal death for infants of mothers with a primary (vs university) education, adjusted for birthweight, increased from 1.99 (95% CI = 1.52, 2.60) in 1989 through 1991 to 2.39 (95% CI = 1.55, 3.70) in 1994 through 1995.
Despite general improvement in the indices of fetal growth and infant survival in the most recent years, social variation in birth outcome in the Czech Republic has increased.
本研究调查了1989年政治变革后捷克共和国出生结局的社会差异。
将1989年、1990年和1991年（n = 380,633）以及1994年、1995年和1996年（n = 286,907）单胎活产的常规收集记录分别与死亡记录相链接。
1989年至1991年间，平均出生体重从3323克降至3292克（P <.001），到1996年又增至3353克。经年龄、胎次和婴儿性别调整后，小学文化程度母亲与大学文化程度母亲的平均出生体重差距从1989年的182克（95%置信区间[CI] = 169, 19）扩大到1996年的256克（95%CI = 240, 272）。早产也呈现类似趋势。在受过良好教育者和已婚者中，新生儿后期死亡率下降最为明显。经出生体重调整后，小学文化程度（与大学文化程度相比）母亲所生婴儿的新生儿后期死亡比值比从1989年至1991年的1.99（95%CI = 1.52, 2.60）增至1994年至1995年的2.39（95%CI = 1.55, 3.70）。
尽管近年来胎儿生长和婴儿存活指标总体有所改善，但捷克共和国出生结局的社会差异仍在增加。
