在早产成年人中没有重大并发症的生存率
Casey Crump1,2, Marilyn A Winkleby3, Jan Sundquist1,2,4
1Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA
|October 23, 2019
概括
大多数过早出生的人活到成年时没有出现严重的并发症,尽管过早出生与更糟糕的结果有关. 这项研究强调了早产后的长期健康状况.
科学领域:
- 产周医学
- 公共卫生
- 流行病学
背景情况:
- 过早分娩是成年人心脏代谢,呼吸和神经精神疾病的已知危险因素.
- 没有重大并发症的早产存活率在很大程度上是未知的.
研究的目的:
- 确定早产者与早产者在成年期没有重大并发症的存活率.
- 评估不同程度的早产所带来的长期健康结果.
主要方法:
- 一项全国性队列研究包括1973年至1997年间在瑞典出生的2,566,699人.
- 随访延长至2015年12月31日,使用青少年和年轻成年人健康结果和患者经验 (AYA HOPE) 共同发病率指数和查尔森共同发病率指数 (CCI) 评估共同发病率.
- 用波桑回归分析计算调整的流行率和差异.
主要成果:
- 总体而言,54. 6% 的早产儿没有出现 AYA HOPE 相关疾病. 根据妊娠年龄有显著差异:极早产的比例为22.3%,极早产的比例为48.5%,晚期产的比例为58.0%,早产的比例为61.2%,而满期产的比例为63.0%.
- 使用CCI,73.1%的早产儿和81.8%的满期婴儿在没有重大并发症的情况下存活.
- 在较早的妊娠年龄中,与满期分娩相比,没有并发症的生存率明显较低.
结论:
- 在1973年至1997年间,大多数早产的瑞典人活到年轻至中年,并没有出现严重的并发症.
- 然而,对于极早出生的人来说,结果明显更糟,这表明需要持续的专业护理和监测.
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