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出生時の妊娠年齢と若年成人期の死亡率
Casey Crump1, Kristina Sundquist, Jan Sundquist
1Department of Medicine, Stanford University, 900 Blake Wilbur Dr, Stanford, CA 94304-2205, USA. kccrump@stanford.edu
JAMA
|September 22, 2011
まとめ
早期出産は,幼児期と青年期におけるより高い死亡率と関連しています. この関連性は,特に先天性異常や呼吸器,内分泌,心血管疾患による死亡の場合,成人期に再現します.
科学分野:
- 産前流行病学 産前流行病学
- 公衆衛生は公衆衛生である.
- 縦断的なコホート研究
背景:
- 早期出産は,先進国における幼児死亡の主な原因である.
- 成人の死亡率に対する出生時の妊娠年齢の長期的な影響は十分に理解されていません.
研究 の 目的:
- 出生時の妊娠年齢と若い成人期における死亡率との関連を調査する.
- 胎児の早産が後の死亡リスクに影響するかどうかを判断する.
主な方法:
- 全国的なコホート研究では,1973年から1979年にかけて生まれた674,820人のスウェーデンのシングレットが対象となり,1歳まで生存しました.
- フォローアップは2008年まで延長され,29歳から36歳までの27,979人の早産児 (妊娠37週未満) を対象とした.
- すべての原因および特定の原因による死亡率は,コックス比例リスクモデルを使用して分析されました.
主要な成果:
- 妊娠年齢と死亡率の強い逆相関は,幼児期 (1-5歳) で観察され,若年成人期 (18-36歳) で再現されました.
- 遅い早産 (34-36週間) を含む早産は,若い成人の死亡率の増加と関連していました.
- 出生時の妊娠年齢は,若い成人期における先天性異常,呼吸器,内分泌,心血管疾患による死亡率と逆に関連していた.
結論:
- 出生時の低妊娠年齢は,幼児期および若年成人期における死亡率増加の独立した危険因子です.
- この研究は,早産が成人期に及ぶ長期的な健康上の影響を強調しています.
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