周末新生儿死亡率与周日新生儿死亡率
Jeffrey B Gould1, Cheng Qin, Amy R Marks
1School of Public Health, University of California, Berkeley, USA. jbgould@stanford.edu
JAMA
|June 12, 2003
概括
周末出生婴儿的新生儿死亡率略高,但考虑到出生体重后,这种差异消失了. 这表明周末的产周护理质量没有妥协.
科学领域:
- 产周医学 产周医学
- 新生儿健康新生儿健康
- 公共卫生 公共卫生
背景情况:
- 有关周末新生儿死亡率的历史性担忧存在.
- 缺乏关于新生儿结局每日变化的当代数据.
- 人们仍然担心周末医疗保健的充分性.
研究的目的:
- 为了比较平日和周末出生之间的新生儿死亡率.
- 评估每日分娩模式,产科干预和病例组合调整后的死亡率.
主要方法:
- 在加利福尼亚州 (1995-1997) 的1,615,041个活产儿的病例系列分析.
- 按出生体重和分娩方式进行分层分析.
- 后勤回归用于估计周末死亡率的出生体重调整几率比率.
主要成果:
- 周末分娩减少了17.5%,剖腹产减少了.
- 较高比例的非常低出生体重婴儿是在周末出生的.
- 观察到的新生儿死亡率在周末更高,但在调整出生体重后,这种差异并不显著.
结论:
- 无论周中的哪一天,实现最佳产周护理的目标至关重要.
- 根据出生体重调整的分析显示,没有证据表明周末在加利福尼亚州的产周护理质量受到损害.
- 研究结果表明,出生体重是理解周末新生儿死亡率差异的关键因素.
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