识别残疾孕妇和产妇和新生儿的结果
Alka Dev1, Willi Horner-Johnson2, Andrew Schaefer1
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
JAMA network open
|March 27, 2025
概括
孕妇的残疾与出生结果不佳有关. 如何识别残疾对这些母亲及其婴儿的感知健康差异产生重大影响.
科学领域:
- 公共卫生 公共卫生
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
背景情况:
- 有残疾的孕妇面临更高的妊娠和分娩不良结果的风险.
- 通过不同的方法识别残疾可以改变该人口中估计的健康差异.
研究的目的:
- 根据各种方法识别孕妇残疾,比较孕妇怀孕和分娩的结果.
- 分析不同残疾识别策略如何影响健康风险的评估.
主要方法:
- 追溯队列研究,利用关联的生命记录和德克萨斯州活产生的医疗补助索赔 (2010-2014).
- 孕产妇的残疾被分为五组:没有残疾,只注册残疾福利,只注册残疾诊断码,两者,或任何定义.
- 结果包括剖腹产,严重孕产妇发病率 (SMM),低出生体重 (LBW),早产 (PTB) 和相对于妊娠年龄的小 (SGA).
主要成果:
- 与没有残疾的妇女相比,残疾诊断代码的妇女的剖腹产,LBW和PTB的比率更高.
- 在只有残疾诊断代码的组中,剖腹产,LBW和PTB的调整后风险比率最高.
- 严重的孕产妇发病率和较小的妊娠年龄风险在残疾福利登记和诊断码的组中最高.
结论:
- 残疾与不良的怀孕和分娩结果有关,无论使用的识别方法如何.
- 观察到的健康差异的程度取决于雇佣残疾人的具体定义.
- 未来对残疾相关健康风险的评估应仔细考虑残疾的概念化和测量.
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