不同群体的妊娠并发症和长期死亡率
Stefanie N Hinkle1, Enrique F Schisterman1, Danping Liu2
1Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.N.H., E.F.S., S.L.M).
Circulation
|March 8, 2023
概括
妊娠并发症如早产和高血压疾病与长期死亡率的增加有关. 尤其对黑人妇女来说, 这些风险突显出孕产妇健康的差异,
科学领域:
- 生殖健康
- 公共卫生
- 流行病学
背景情况:
- 怀孕并发症是未来心脏代谢疾病和死亡的已知危险因素.
- 此前关于这一主题的研究基本上排除了种族多样性的人口.
- 了解这些不同群体的关联对于解决健康差异至关重要.
研究的目的:
- 在一个种族多样化的群体中调查妊娠并发症与整体和特定原因死亡率之间的关联.
- 为了确定这些关联是否在黑人和白人孕妇之间有所不同.
- 评估妊娠并发症对健康的长期影响.
主要方法:
- 采用了协作周产期项目 (1959-1966) 的数据,这是一个前性队列研究.
- 将参与者数据与国家死亡指数和社会保障死亡总档联系起来,以确定到2016年的死亡率.
- 使用考克斯模型估计与早产,妊娠高血压疾病和妊娠糖尿病/葡萄糖耐受性受损相关的调整风险比,控制多种共变量.
主要成果:
- 妊娠并发症,包括早产 (各种类型),高血压疾病 (叠加性妊娠前/ 妊娠后) 和妊娠糖尿病/ 葡萄糖耐受性受损与全因死亡率的增加有关.
- 与白人参与者相比,黑人参与者的早产发病率和整体死亡率更高.
- 观察到不同的关联:早产导致黑人参与者的死亡风险更高,而早产剖腹产对白人参与者的风险更高.
结论:
- 妊娠并发症与增加的死亡风险有显著的关联,在怀孕后持续近50年.
- 黑人与白人之间的并发症发生率和随后的死亡风险差异凸显了怀孕对健康的终身影响.
- 解决孕妇健康方面的差异对于减轻长期死亡风险和改善健康公平至关重要.
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