在nuMoM2b队列中的妊娠前条件和不良孕产妇结果的种族/种族差异:基于人口的队列研究
Meghan E Meredith1, Lauren N Steimle1, Kaitlyn K Stanhope2
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America.
PloS one
|August 12, 2024
概括
预先存在的疾病,如心血管问题,可能会解释一些严重妊娠前风险的种族差异. 纳入这些健康因素可以改善孕妇风险预测模型.
科学领域:
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
- 心血管健康 心血管健康
背景情况:
- 种族和民族少数群体的子群体经历不成比例地更高的不良孕产妇结果率.
- 预先存在的疾病是已知的妊娠并发症的风险因素.
- 了解先前存在的疾病和种族在孕产妇健康中的相互作用对于有针对性的干预至关重要.
研究的目的:
- 调查先前存在的疾病对种族差异在不利的孕产妇结果的贡献.
- 将这些条件整合到风险预测模型中,以提高少数群体子组的准确性.
主要方法:
- 对无卵性妊娠结果研究的分析:监测即将成为母亲的 (nuMoM2b) 队列 (n=8729).
- 多病症的定义是存在两个或两个以上的妊娠前疾病.
- 使用加权波桑回归和调度分析来评估条件对差异的影响.
- 使用接收器操作特征曲线 (AUC) 下面的面积来评估模型性能.
主要成果:
- 考虑到先前存在的疾病减轻了非西班牙裔黑人种族/种族与严重产前之间的关联.
- 心血管和脏疾病与严重孕前的风险增加有显著关联.
- 心血管疾病部分解释了非西班牙裔黑人人非西班牙裔黑人非西班牙裔黑人非西班牙裔黑人非西班牙裔黑人非西班牙裔非西班牙裔黑人非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙裔非西班牙人非西班牙人非西班牙人非西班牙人非西班牙人非西班牙人.
- 包括怀孕前的情况提高了风险模型的预测性能.
结论:
- 预先存在的疾病,特别是心血管问题,似乎调解了在严重的孕前中观察到的一些种族差异.
- 识别并将特定的并发症纳入风险预测模型可以提高准确性,并可能减少脆弱人群中母亲的不良结果.
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