英国与瑞典的儿童死亡率:出生队列研究
Ania Zylbersztejn1, Ruth Gilbert2, Anders Hjern3
1The Farr Institute of Health Informatics Research, London, UK; Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Lancet (London, England)
|May 8, 2018
概括
英国的儿童死亡率高于瑞典,主要是由于出生时的不良特征. 改善孕产妇健康和减少社会经济劣势是减少儿童死亡的关键.
科学领域:
- 公共卫生
- 流行病学
- 儿童医学
背景情况:
- 英国的儿童死亡率几乎是瑞典的两倍.
- 在英格兰和瑞典的儿童死亡率上存在很大的差异.
研究的目的:
- 为了确定不利的出生特征和社会经济因素如何解释英格兰和瑞典儿童死亡率的差异.
- 在不同年龄组中比较英格兰和瑞典的儿童死亡风险.
主要方法:
- 分析了来自英格兰和瑞典的单子生育群 (2003-2012).
- 使用Cox比例危险回归模型来比较死亡风险,并根据出生特征和社会经济因素进行调整.
- 死亡率在2至27天,28至364天和1至4岁之间进行评估.
主要成果:
- 与瑞典相比,英格兰的未调整死亡风险在2 - 27天 (HR 1.66) 和28 - 364天 (HR 1.59) 中显著增加.
- 在英格兰,2~27天的高风险占77%;28~364天的高风险占68%.
- 社会经济因素解释了过度风险的比例较小,特别是在出生后的第一个月.
结论:
- 英国儿童死亡率高的原因在很大程度上归因于不良出生特征的分布.
- 社会经济因素通过与不良出生结果和新生儿死亡率的增加起作用.
- 针对母亲健康和社会经济劣势的干预措施对于降低英格兰儿童死亡率至关重要.
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