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产期出生的时间和相关的死亡风险:欧洲28个国家的生态分析.
Jóhanna Gunnarsdóttir1,2, Marianne Philibert3, Mika Gissler4,5
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
概括
在早产率较高的国家,死产率较低,这可能表明选择性诱导或剖腹产较少. 然而,围产期死亡率在各组之间没有显著差异.
科学领域:
- 围产期流行病学 围产期流行病学
- 公共卫生 公共卫生
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 过早分娩 (3738周) 通常是选择性分娩实践的代理.
- 了解早产率与死亡率之间的关系对于优化产科护理至关重要.
研究的目的:
- 调查欧洲各国的早产率与死产和产前死亡率之间的关联.
- 评估较高的早产率是否与不同的死亡结果相关.
主要方法:
- 生态研究利用来自28个欧洲国家的国家出生数据 (20152020).
- 各国根据早产婴儿的百分比被分为三级 (低,中,高).
- 随机效应的元分析比较了群体之间每1000个出生 (≥37周) 的死产和产周死亡率.
主要成果:
- 早期出生率的差异很大 (17.8%至49.1%).
- 在较高的早产三分之一 (1.05/1000) 与最低的 (1.28/1000) (p=0.05) 相比,聚合的死胎率较低.
- 在三级之间没有观察到围产期死亡率的显著差异 (p=0.71).
结论:
- 虽然死亡出生率往往较低,早期出生率较高,但由于显著的异质性,这一关联需要仔细解释.
- 周产期死亡率在不同组之间没有显著差异,这表明复杂的因素影响了选择性出生时间之外的结果.
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