イギリスとスウェーデンにおける幼児死亡率:出生コホート研究
Ania Zylbersztejn1, Ruth Gilbert2, Anders Hjern3
1The Farr Institute of Health Informatics Research, London, UK; Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Lancet (London, England)
|May 8, 2018
まとめ
幼児死亡率はスウェーデンよりもイギリスで高く,主に出生時に不良な特徴が原因です. 母親の健康を改善し,社会経済的に不利な立場を減らすことは,子供の死亡率を減らすための鍵です.
科学分野:
- 公衆衛生
- エピデミオロジー
- 小児科
背景:
- イギリスの幼児死亡率はスウェーデンのほぼ2倍です.
- イギリスとスウェーデンでは 幼児死亡率の格差が大きい.
研究 の 目的:
- イギリスとスウェーデンの間の幼児死亡率の違いを,不利な出生特徴と社会経済的要因がどの程度説明できるかを調べる.
- イギリスとスウェーデンの子供の死亡率を 比較するために
主な方法:
- イギリスとスウェーデンのシングルトン生児 (2003年−2012年) の全国的に代表的な集団を分析した.
- コックス比例ハザード回帰モデルを使用して,出生特徴と社会経済的要因を調整して死亡リスクを比較した.
- 死亡率は2〜27日,28〜364日,および1〜4年の年齢で評価された.
主要な成果:
- イギリスは,スウェーデンと比較して,2~27日 (HR1. 66) と28~364日 (HR1. 59) で著しく高い非調整死亡リスクを示した.
- イギリスでは2~27日における過剰リスクの77%と28~364日における過剰リスクの68%が不良出生特性によって説明されている.
- 社会経済的な要因は,特に最初の1ヶ月後に,過剰なリスクの割合が低いことを説明しました.
結論:
- イギリスの幼児死亡率の上昇は,主に不良な出生特徴の不良分布に起因する.
- 社会経済的な要因は 産後不良の結果や 新生児死亡率の増加と関連して 重要な役割を果たしています
- 母の健康と社会経済的不利益を 対象とした介入は イギリスの幼児死亡率を 減らすために不可欠です
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