美国县级早产率的变化,2007-2019年
Sadiya S Khan1,2, Adam S Vaughan3, Katharine Harrington2
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA network open
|December 8, 2023
概括
过早出生率在美国各县之间显示出显著的地理差异,掩盖了国家稳定. 社会脆弱性与更高的发病率有关,这凸显了需要局部干预措施来减少可预防的婴儿死亡率的必要性.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 孕产妇和儿童的健康
背景情况:
- 早产是婴儿死亡率和发病率的主要原因之一.
- 国家早产率可能会掩盖县级的关键地理差异和趋势.
研究的目的:
- 从2007年到2019年,估计美国各县的年龄标准化早产率.
- 分析县级的地理差异和早产率的趋势.
主要方法:
- 使用了连续横截面研究设计,使用了美国国家卫生统计中心的数据 (2007-2019).
- 使用经过验证的小面积估计模型 (层次化的贝叶斯空间时间模型) 计算年龄标准化的早产率.
- 采用日志线性回归来评估早产率的变化及其与社会脆弱性指数的关联.
主要成果:
- 观察到早产率的显著地理差异,最高和最低百分位数县之间有显著差异.
- 与加利福尼亚州和新英格兰州相比,东南地区的县一直呈现出更高的利率.
- 虽然全国的出生率保持稳定,但近6个县中有1个县出现了增加;较高的社会脆弱性指数四分位数与高的早产率相关.
结论:
- 在早产和早期早产出生率存在实质性的地理差异,与基于地点的社会劣势有关.
- 在全国范围内早产率的稳定性掩盖了许多个别县的增加.
- 研究结果强调了解决局部社会决定因素的重要性,以减轻早产差异.
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