怀孕年龄特定的死产率:我们使用的是正确的分母吗?
Jessica Sexton1, Aleena M Wojcieszek1, Georgina M Chambers2
1NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland, Brisbane, Queensland, Australia.
Paediatric and perinatal epidemiology
|December 5, 2024
概括
在全球范围内,每年有近200万名婴儿死产. 这项研究表明,风险胎儿 (FAR) 或连续性校正风险胎儿 (ccFAR) 率,而不是标准死产率,准确地反映了整个怀孕期间的死产风险.
科学领域:
- 围产期流行病学 围产期流行病学
- 生殖健康 生殖健康
- 生物统计学 生物统计学
背景情况:
- 死亡出生仍然是一个重要的全球关注,每年有近200万例.
- 标准死产率虽然有用,但却掩盖了关键的妊娠年龄特定趋势.
- 了解不同妊娠年龄的确切风险对于干预至关重要.
研究的目的:
- 分析和批评1998-2018年澳大利亚死产趋势.
- 用三种不同的方法计算和比较妊娠年龄特定的死产率.
- 评估妊娠年龄特定死产率 (GS-SBR),风险胎儿 (FAR) 和连续性校正风险胎儿 (ccFAR) 计算的准确性.
主要方法:
- 澳大利亚国家围产期数据收集 (1998-2018) 的横截面分析.
- 死产被定义为从怀孕20周或400克起的出生.
- 应用GS-SBR (出生分母),FAR (周初胎儿分母) 和ccFAR (周中期胎儿分母).
主要成果:
- 在590万例新生儿 (每1000例6.7例) 中发生了39576例死产.
- GS-SBR的差异很大 (1.0-790.0/1000个出生).
- 与GS-SBR.不同的是,FAR和ccFAR显示随着孕期的推进而增加死产风险,与GS-SBR.不同.
结论:
- 风险胎儿 (FAR) 和连续性校正风险胎儿 (ccFAR) 方法在整个怀孕期间提供了更准确的死产概率.
- 这些先进的方法更好地告知临床医生关于不断变化的风险.
- 准确的妊娠年龄特定风险评估对于及时的临床行动至关重要.
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