妊娠 合併症 と 長期 的 死亡 率
Stefanie N Hinkle1, Enrique F Schisterman1, Danping Liu2
1Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.N.H., E.F.S., S.L.M).
Circulation
|March 8, 2023
まとめ
妊娠中の合併症である早産や高血圧症は 長期的な死亡率の増加と関連しています このリスクは,特に黒人女性にとって,生涯にわたる影響を持つ母親の健康における格差を強調しています.
科学分野:
- 生殖 健康
- 公衆衛生
- 流行病学について
背景:
- 妊娠中の合併症は,将来の心臓代謝疾患と死亡率の危険因子として知られています.
- このテーマに関する以前の研究は 人種的に多様な集団を大きく排除していた.
- 健康格差に対処するために これらの関連性を理解することは 極めて重要です
研究 の 目的:
- 妊娠中の合併症と全体的および因果的な死亡率との関連を調査する.
- 白人と黒人の妊婦の関係が 異なるかどうかを調べるため
- 妊娠中の合併症の長期的な健康への影響を評価する.
主な方法:
- コラボレーティブ・ペリナタル・プロジェクト (1959年−1966年) のデータを活用し,前向きなコホート研究を行った.
- 2016年までの死亡率の確認のため,参加者のデータを国家死亡指数と社会保障死亡マスターファイルにリンクした.
- 早期出産,妊娠中の高血圧障害,妊娠中の糖尿病/グルコース耐性障害に関連する死亡率の調整されたハザード比を推定するためにコックスモデルを使用した.
主要な成果:
- 妊娠中の合併症 (様々なタイプの早産),高血圧性疾患 (重複性妊娠中出血症/妊娠中出血症),妊娠中の糖尿病/グルコース耐性障害は全因死亡率の増加と関連していました.
- 黒人の参加者は白人の参加者に比べて早産の発生率と全体的な死亡率が高い.
- 異なる関連性が見られた.早産による出産は黒人参加者の死亡リスクが高く,早産前の剖腹產は白人の参加者の死亡リスクが高かった.
結論:
- 妊娠後の50年近く続く妊娠合併症は,死亡率の上昇と有意に関連しています.
- 合併症の発生率とそれに伴う死亡リスクの違いが 白人と黒人の間に見られることは 妊娠が生涯にわたって健康に与える影響を強調しています
- 妊婦の健康に関する格差を克服することは,長期的な死亡リスクを軽減し,健康の公平性を改善するために不可欠です.
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