阿普加得分和因特定原因的婴儿死亡风险:基于人口的队列研究
Stamatina Iliodromiti1, Daniel F Mackay2, Gordon C S Smith3
1School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Lancet (London, England)
|September 20, 2014
概括
在5分钟的Apgar分数低与新生儿和婴儿死亡风险增加密切相关. 这项研究证实了Apgar得分.
科学领域:
- 新生儿健康 新生儿健康
- 围产儿医学 围产儿医学
- 公共卫生 公共卫生
背景情况:
- 60多年来,Apgar评分一直是评估新生儿状况的全球标准.
- 新生儿护理的进步需要重新评估Apgar评分的当前临床相关性.
- 该研究调查了5分钟Apgar分数与新生儿/婴儿死亡风险之间的关联.
研究的目的:
- 为了确定5分钟的阿普加尔评分和新生儿死亡率之间的关系的强度.
- 评估5分钟的阿普加尔评分和婴儿死亡率之间的关联.
- 分析与Apgar分数相关的特定原因细分的死亡风险.
主要方法:
- 相关的苏格兰出生分娩和死亡率数据 (1992-2010年) 单个活产.
- 排除了先天异常或异免疫的婴儿;分析了22-44周的妊娠年龄.
- 使用二项式日志线性建模计算相对风险 (RRs) 低 (0-3) 和中等 (4-6) 阿帕尔分数与正常 (7-10),调整混因素和按妊娠年龄分层.
主要成果:
- 低的5分钟Apgar分数与所有妊娠年龄的新生儿和婴儿死亡率增加显著相关.
- 这种关联在预产期最强,低阿普加 (0-3) 的RR达到359.4的早期新生儿死亡和50.2的婴儿死亡.
- 低阿巴格的最强的关联被观察到因无氧死亡;没有发现与突然婴儿死亡综合征的联系.
结论:
- 低于5分钟的阿普加尔评分是新生儿和婴儿死亡率的强有力的预测指标.
- 这些发现支持阿普加尔评分在当代产科和新生儿实践中的持续临床实用性.
- 阿普加尔评分仍然是新生儿风险分层的一个有价值的工具.
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