与瑞典家庭政策相关的意外产周健康后果
Enrico Debiasi1,2, Helena Honkaniemi1,2, Siddartha Aradhya3
1Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
JAMA pediatrics
|April 8, 2024
概括
瑞典的速度溢价政策,旨在支持育儿假,与早产儿的增加有关. 仔细的家庭政策设计至关重要,以防止意外的负面影响产周健康.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 生殖健康 生殖健康
背景情况:
- 瑞典1980年和1986年的"速度溢价"政策旨在保护因分娩间隔较短而获得的育儿假福利.
- 这些政策可能间接地鼓励分娩间隔缩短和母亲年龄增加,这些都是已知的围产期不良结果的风险因素.
研究的目的:
- 评估1980年至1986年的瑞典速度溢价政策与围产期健康结果之间的关联.
主要方法:
- 采用瑞典医疗出生登记处1974-1991年数据进行的横截面研究 (1,762,784例单独分娩).
- 用细分后勤回归进行中断时间序列分析,以评估早产,低出生体重,早产时小于妊娠年龄 (SGA) 和死产的几率.
- 分组分析是按母亲的起源进行的.
主要成果:
- 1980年的政策与每月早产率增加0.3%有关 (OR,1.0029).
- 在1986年政策放松后,早产的几率每月下降0.5% (OR,0.9951).
- 低出生体重遵循类似的模式;早产SGA在1980年后下降,而死胎没有显著变化. 主要观察到的变化是瑞典和北欧出生的母亲的出生.
结论:
- 尽管有经济效益,但速度溢价政策与不良围产期健康结果有关,特别是早产.
- 家庭政策需要精心设计,考虑对生育行为和围产期健康的潜在意外后果.
- 建议在制定家庭政策时采用"所有政策中的健康"方法.
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