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出生时的妊娠年龄和年轻成年人的死亡率
Casey Crump1, Kristina Sundquist, Jan Sundquist
1Department of Medicine, Stanford University, 900 Blake Wilbur Dr, Stanford, CA 94304-2205, USA. kccrump@stanford.edu
JAMA
|September 22, 2011
概括
过早分娩与儿童早期和年轻成年期的死亡率更高有关. 这种关联在成年后再次出现,特别是因先天性异常和呼吸道,内分泌和心血管疾病的死亡.
科学领域:
- 围产期流行病学 围产期流行病学
- 公共卫生 公共卫生
- 纵向队列研究是指纵向队列研究.
背景情况:
- 在发达国家,早产是婴儿死亡的主要原因.
- 妊娠年龄在出生时对成年人死亡率的长期影响尚不清楚.
研究的目的:
- 调查出生时妊娠年龄与年轻成人死亡率之间的关联.
- 为了确定早产是否会影响晚年死亡风险.
主要方法:
- 一项国家队列研究包括674,820名出生于1973-1979年的瑞典单身者,他们活到1岁.
- 随访延长至2008年,覆盖了27,979名早产 (<37周妊娠) 个体的29-36岁.
- 使用考克斯比例危险模型分析了全因和因特定死亡率.
主要成果:
- 怀孕年龄和死亡率之间的强烈反向关联在幼儿时期 (1-5岁) 观察到,并在年轻成人时期 (18-36岁) 重新出现.
- 早产,包括晚期早产 (34-36周),与年轻成年人死亡率的增加有关.
- 出生时的妊娠年龄与年轻成年人患先天性异常,呼吸道,内分泌和心血管疾病的死亡率相反相关.
结论:
- 出生时的低妊娠年龄是儿童早期和年轻成人死亡率增加的独立风险因素.
- 这项研究强调了早产到成年后的长期健康后果.
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