2013年至2016年在费城的两家医院中,社区可行性作为早产现象的风险因素
Theresa A Kash1, Rachel F Ledyard2, Anne M Mullin3
1Center for Public Health Initiatives, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
概括
邻居可行性可能会降低医学上指示的早产 (mPTB) 的风险,但不会降低自发的早产 (sPTB). 对于黑人母亲来说,没有观察到保护作用,这突出了城市规划对健康公平的需求.
科学领域:
- 环境健康 环境健康
- 围产期流行病学 围产期流行病学
- 城市规划 城市规划
背景情况:
- 过早分娩 (PTB) 影响美国10分之一的婴儿,种族差异很大.
- 社区特征,包括可行性,越来越多地被认为是PTB的潜在贡献者.
- PTB呈现为自发性 (sPTB) 或医学上指示的 (mPTB),具有明显的潜在原因.
研究的目的:
- 调查社区可行性与sPTB和mPTB风险之间的关联.
- 检查这些关联是否因PTB表型而有所不同.
- 探索可行性的保护作用的潜在基于种族的差异.
主要方法:
- 费城出生队列的分析 (n=19,203).
- 使用Walk Score®排名量化社区可行性的量化.
- 种族分层分析以评估可行性和PTB表型之间的关联差异.
主要成果:
- 增加的可行性与医学上指示的早产 (mPTB) (aOR 0.90) 的几率降低有关.
- 在行走能力和自发早产 (sPTB) (aOR 1.04) 之间没有发现显著的关联.
- 与白人患者 (aOR 0.87) 相比,黑人患者 (aOR 1.05) 的显著相互作用 (p=0.03) 表示可行性对mPTB没有保护性.
结论:
- 邻里可步行可能会降低医学上指示的早产的风险.
- 在mPTB上,可行性的保护性关联在种族群体之间并不公平.
- 城市规划干预措施应考虑社区可行性,以促进出生结果的健康公平.
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