死产与在怀孕确认时已知的危险因素之间的关联
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555, USA.
JAMA
|December 15, 2011
概括
死产是婴儿死亡的主要原因,许多风险因素可以在怀孕早期确定. 然而,这些因素只解释了一小部分死产病例,突出了对这一关键结果的理解上的差距.
科学领域:
- 围产期流行病学 围产期流行病学
- 生殖健康 生殖健康
- 公共卫生 公共卫生
背景情况:
- 死产占美国在怀孕20周至1岁之间死亡的近一半.
- 现有关于死胎风险因素的研究通常依赖于有限的生命统计数据.
研究的目的:
- 调查死产与在怀孕确认时可识别的风险因素之间的关联.
- 评估这些因素对观察到的死亡出生率种族差异的贡献.
主要方法:
- 从2006年3月到2008年9月,进行了一项基于人口的多站点病例控制研究.
- 从59家美国医院收集数据,包括活产和所有死产病例的代表样本.
- 过量采样用于早产 (<32周妊娠) 和非洲裔婴儿.
主要成果:
- 对614例死产病例和1816例对照病例的分析确定了独立的风险因素,包括非西班牙裔黑人种族/种族,以前的死产,无双性,糖尿病,晚期母亲年龄 (≥40岁),母亲的AB血型,吸毒史,吸烟,肥胖/超重,不与伴侣生活,以及多元性.
- 调整后的赔率比率 (AORs) 为这些因素在1.55到5.91之间.
- 一般化的R平方值为0.19,表明这些因素解释了死胎变异的有限量.
结论:
- 在怀孕确认时,可以识别出几个死胎的危险因素.
- 这些已知的风险因素共同占死亡出生结果总体差异的很小比例.
- 需要进行进一步的研究,以确定导致死产的其他因素,特别是解释种族差异的因素.
相关概念视频
Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Pathophysiology of Diabetes
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Probability Laws
Overview
Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...


