低出生体重と早産との関連
Clare C Brown1, Jennifer E Moore2,3, Holly C Felix1
1Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock.
JAMA
|April 24, 2019
まとめ
メディケイドの拡大は 低出生体重や早産の総割合を 大きく変化させなかった. しかし,黒人乳児と白人乳児のこれらの結果の格差の減少と関連していました.
科学分野:
- 公衆衛生
- 医療サービス研究
- 生後流行病学
背景:
- 低出生体重と早産は 赤ん坊の健康の重要な指標であり,特に黒人の赤ん坊に重大な人種的差異がある.
- 幼児死亡率の増加と 長期的な健康問題に関連しています
研究 の 目的:
- メディケイドの拡大が 低出生体重と早産の割合に影響したか 調べるためでした
- これらの出生結果における人種的,民族的格差に対するメディケイドの拡大の影響を評価する.
主な方法:
- 2011年から2016年の米国国立保健統計センターのデータを活用し,1500万件以上の出産をカバーしました.
- 差異の差異 (DID) と差異の差異の差異 (DDD) のモデルを使用して,メディケイドの拡大状態と拡大していない状態の結果を比較しました.
- 19歳以上の女性のシングルトン生児を分析し,人種/民族によって階層化しました.
主要な成果:
- メディケイドの拡大に関連した早産,非常に早産,低出生体重,または非常に低出生体重の全体的な変化は観察されなかった.
- メディケイドの拡大州では,黒人乳児と白人乳児の格差が4つの出産結果すべてで著しく減少した.
- ヒスパニック系乳児の相対的な差異には大きな変化は見られなかった.
結論:
- 州のメディケイドの拡大は,低出生体重または早産率の全体的な改善と有意に関連しませんでした.
- メディケイドの拡大は 黒人の赤ちゃんの出生における人種差を減らすことで ポジティブな影響を示しました
- 調査結果は,メディケイドの拡大が 特定の健康上の不平等を軽減する可能性を強調しています.
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