妊娠確認時に知られている死産とリスク因子の関連性
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555, USA.
JAMA
|December 15, 2011
まとめ
死産は乳児死亡の主な原因であり,多くのリスク要因は妊娠初期に特定できます. しかし,これらの要因は死産症例のほんの一部を説明するだけで,この重要な結果を理解する際のギャップを強調しています.
科学分野:
- 産前流行病学 産前流行病学
- 生殖器の健康については,
- 公衆衛生は公衆衛生である.
背景:
- 死産は,妊娠20週から1歳までの米国での死亡のほぼ半分を占めています.
- 死産の危険因子に関する既存の研究は,多くの場合,限られた生命統計データに基づいています.
研究 の 目的:
- 妊娠確認時に特定できる死産と危険因子の関連性を調査する.
- 死産率における観察された人種差異に対するこれらの要因の寄与を評価する.
主な方法:
- 2006年3月から2008年9月まで,人口を対象とした複数のサイトを対象とした症例対照研究が行われました.
- データは59の米国の病院から収集され,生児の代表的なサンプルとすべての死産症例を含む.
- 過剰サンプリングは,早産 (妊娠32週未満) とアフリカ系の子どものために使用されました.
主要な成果:
- 614例の死産症例と1816例の対照群の分析により,非ヒスパニック系黒人人種/民族,以前の死産,ヌリパリティ,糖尿病,母親の年齢 (≥40歳),母親のAB型血液型,薬物中毒歴,喫煙,肥満/超重量,パートナーと暮らしていない,および多元性を含む独立したリスク要因が特定されました.
- 調整されたオッズ比 (AORs) は,これらの要因に対して1.55から5.91の範囲であった.
- 一般化されたR二乗値は0.19で,これらの要因が死産の変動の限られた量を説明することを示しています.
結論:
- 死産のいくつかのリスク要因は,妊娠の確認時に特定することができます.
- これらの既知のリスク要因は,死産の結果の全体的なバリエーションのわずかな割合を占めています.
- 死産に寄与する他の要因,特に人種差異を説明する要因を特定するために,さらなる研究が必要である.
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