在纽约的产前护理机构中,早产率的变化
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
|November 11, 2023
概括
根据产前护理地点,早产率有很大差异,即使在调整了风险因素之后. 这表明,未测量的特定地点因素会影响分娩结果,需要进一步调查不同设施的护理服务.
科学领域:
- 孕产妇和儿童的健康
- 医疗保健质量和研究成果研究成果
- 流行病学 流行病学
背景情况:
- 过早分娩仍然是一个重要的公共卫生问题,新生儿患病率和死亡率很高.
- 医疗保健提供环境的变化可能会导致出生结果的差异.
- 了解特定地点对早产的影响对于改善产前护理质量至关重要.
研究的目的:
- 根据获得产前护理的特定地点,调查早产率的变化.
- 确定产前护理地点是否是早产风险的独立预测因素.
主要方法:
- 一项采用纽约医疗补助申请和单独活产婴儿遭遇数据的横截面队列研究 (N=154,377).
- 使用地理编码的计费地址识别出产前护理地点.
- 进行了后勤回归分析,以根据地点确定原始和风险调整的早产率.
主要成果:
- 在不同地点,早产率从2.0%到18.7%不等,平均为7.8%.
- 风险调整后的早产率差异很大,第90百分位数是第10百分位数的2.7倍.
- 这种变化并不能完全由出生量,农村位置或患者人口统计学来解释.
结论:
- 在不同产前护理场所,风险调整过早分娩率存在显著差异.
- 除了个体患者的人口统计和病史之外的因素也导致了这些观察到的变化.
- 需要进一步的研究来阐明与更高的早产风险相关的特定地点级因素.
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