早期 出産 の 成人 者 の 中 で 大 規模 な 併発 症 を 伴わ ず に 生存 する 割合
Casey Crump1,2, Marilyn A Winkleby3, Jan Sundquist1,2,4
1Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA
|October 23, 2019
まとめ
大半の未熟児は 大人になるまで 大変な併発性疾患を患わずに 生き延びていますが 極端に未熟児の出産は より悪い結果につながっています この研究は早産の生存者の 長期的な健康状態を強調しています
科学分野:
- 産経内科
- 公衆衛生
- 流行病学
背景:
- 早期出産は成人の心代謝,呼吸器系,神経精神疾患の危険因子として知られています.
- 主要な併発性疾患のない早産の生存率は,ほとんど不明です.
研究 の 目的:
- 成人期に伴う大きな合併症のない生存率を早産児と早産児の比較で決定する.
- 早期出産の度合いに伴う 長期的な健康上の結果を評価する.
主な方法:
- スウェーデンで1973年から1997年の間に生まれた2,566,699人を対象に全国的なコホート研究が行われました.
- フォローアップは2015年12月31日まで延長され,青少年および若年成人の健康結果および患者経験 (AYA HOPE) 併発症指数およびチャールソン併発症指数 (CCI) を使用して併発症を評価した.
- 調整された流行比率と差異を計算するために,ポッソン回帰分析を使用した.
主要な成果:
- AYA HOPEの併発性疾患は発生しなかった. これは妊娠年齢によって著しく変化しました:非常に早産の22.3%,非常に早産の48.5%,遅い早産の58.0%,早産の61.2%,満期出産の63.0%です.
- CCIを用いて,早産の73. 1%,満期出産の81. 8%が大きな併発症なしに生存しました.
- 早期妊娠年齢では,満期出産と比較して生存率が著しく低いことが観察されました.
結論:
- スウェーデンでは1973年から1997年の間,早産児のほとんどは,大きな併発性疾患を伴わずに,成人期前期から中期まで生存しました.
- しかし 極めて早産児の場合は 結果が著しく悪かったため 専門的なケアとモニタリングの必要性を 示すことが分かりました
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