在2015年至2020年期间,美国与孕产妇肥胖相关的围产死亡趋势
Ruofan Yao1, Jordan Rossi1, Hoang Yen Nguyen1
1Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, California.
American journal of perinatology
|January 9, 2025
概括
围产死亡率在2019年下降,可能是由于政策变化,但在2020年增加,可能是由于COVID-19. 趋势因体重指数 (BMI) 类别而异.
科学领域:
- 产科和妇科 产科和妇科
- 围产期健康 围产期健康
- 公共卫生 公共卫生
背景情况:
- 肥胖是已知的死产和新生儿死亡的风险因素.
- 2018年的ARRIVE试验影响了产科实践,导致更多的39周分娩.
- 了解身体质量指数 (BMI) 类别的围产期死亡率趋势对于有针对性的干预至关重要.
研究的目的:
- 分析2015年至2020年不同体质指数 (BMI) 类别中围产死亡率的趋势.
- 评估产科政策和实践变化对围产期结果的影响.
- 确定COVID-19大流行对围产死亡率的潜在影响.
主要方法:
- 美国出生 (2015-2020) 的回顾性队列研究.
- 按BMI类别计算死产,婴儿死亡和围产死亡率.
- 逻辑回归用于基于2015-2018年数据进行比较,预测2019-2020年利率.
主要成果:
- 死亡出生率在2015-2018年间随着BMI类别的上升而增加.
- 新生儿死亡率在大多数BMI类别下降,除了体重不足组.
- 从2015年到2018年,围产死亡率普遍上升,但在2019年大多数BMI类别下降,除了体重不足.
- 与预测相比,婴儿死亡率在2020年所有BMI类别中都增加.
结论:
- 围产期死亡率在2019年有所改善,扭转了之前的上升趋势.
- 观察到的改善可能与ARRIVE试验后39周分娩的增加有关.
- 积极的趋势并没有持续到2020年,潜在的负面影响归因于COVID-19大流行.
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