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新生児死亡率は,週末の新生児死亡率と,平日の新生児死亡率を比較したものです
Jeffrey B Gould1, Cheng Qin, Amy R Marks
1School of Public Health, University of California, Berkeley, USA. jbgould@stanford.edu
JAMA
|June 12, 2003
まとめ
週末に生まれた新生児の新生児死亡率はわずかに高かったが,出生体重を考慮するとこの差は消えた. これは,週末の周期の介護の品質に妥協がないことを示唆しています.
科学分野:
- 産周医学は,産周医学である.
- 新生児の健康について
- 公衆衛生は公衆衛生である.
背景:
- 週末の新生児死亡率に関する歴史的な懸念は存在しています.
- 新生児のアウトカムの日々の変動に関する現代的なデータは不足しています.
- 週末の医療の充実に対する懸念は依然として残っています.
研究 の 目的:
- 新生児死亡率を平日の出産と週末の出産を比較する.
- 出産,産科介入,症例ミックス調整による死亡率の毎日のパターンを評価する.
主な方法:
- カリフォルニア州 (1995年-1997年) で生まれた生児1,615,041例のケースシリーズ分析.
- 出産時の体重と出産方法による分層分析.
- 週末死亡率の出生体重調整オッズ比率を推定するために使用されるロジスティック回帰.
主要な成果:
- 週末の出産は17.5%減少し,帝王切開による出産も減少した.
- 低出生体重の赤ちゃんの割合は,週末に多く出産しています.
- 観察された新生児死亡率は週末に高かったが,出生体重を調整した後にこの違いは有意ではなかった.
結論:
- 週日に関係なく,最適な産後介護の目標は極めて重要です.
- 産後体重調整による分析は,カリフォルニア州で週末に産前介護の質が損なわれた証拠はないことを明らかにした.
- 発見は,出生体重が週末新生児死亡率の違いを理解する上で重要な要因であることを示しています.
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