流行病预产悖论:对竞争解释的测试
Ralph A Catalano1, Tim A Bruckner2, Alison Gemmill3
1School of Public Health, University of California, Berkeley, CA 94704, United States.
American journal of epidemiology
|June 17, 2024
概括
流行性早产悖论,即COVID-19期间早产量下降,最好通过先前的怀孕流产来解释. 这表明风险较小的胎儿,而不是减少的流行病压力,导致了下降.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 生殖健康 生殖健康
背景情况:
- 新冠肺炎 (COVID-19) 疫情给孕妇带来了前所未有的压力.
- 社会距离和封锁限制了获得产前护理和社会支持的机会.
- 疫情期间在高收入国家观察到的早产率下降呈现出了一个科学悖论.
研究的目的:
- 调查"流行病早产悖论",并测试拟议的解释.
- 为了确定在疫情初期观察到的早产儿数量下降的最节的解释.
主要方法:
- 时间序列建模应用于美国的月度受孕队列数据.
- 数据跨越2013年7月至2020年2月,涵盖80个队列.
- 评估了对悖论的三种可能解释.
主要成果:
- 该研究发现",先前损失"假设最好地解释了现有数据.
- 这种假设认为,自发流产和死胎的增加减少了处于早产风险的胎儿数量.
- 推断出早产率的下降是由于风险较小的胎儿人口的后果.
结论:
- "先前损失"理论为流行病早产悖论提供了最令人信服的解释.
- 这些发现对公共卫生危机期间关于怀孕和胎儿健康的公共卫生策略有重大影响.
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