与唐氏综合症胎儿减少相关的全国变量
Petrus H F M van Casteren1, Gert de Graaf2, Frank Buckley3,4
1Amsterdam School of Economics, University of Amsterdam, Amsterdam, the Netherlands.
American journal of medical genetics. Part A
|August 21, 2025
概括
政府对产前查的政策显著减少了唐氏综合征 (DS) 的活产. 增加查的可用性和补偿,以及母亲的年龄和收入,与选择性终止导致的DS出生率相对相关.
科学领域:
- 公共卫生
- 遗传学
- 健康经济学
背景情况:
- 在全球范围内,对于唐氏综合征 (DS) 的产前查变得更加容易.
- 宏观经济政策影响医疗保健的获取和结果,包括生殖健康选择.
- 对于公共卫生规划来说, 了解政策对DS出生率的影响至关重要.
研究的目的:
- 分析宏观经济政策决策与患有唐氏综合征的活产之间的关联.
- 模拟产前查可用性和补偿对DS减少百分比的影响.
- 确定影响选择性终止妊娠的因素.
主要方法:
- 使用基于母亲年龄的流行模型和出生数据估计了DS活产减少的日志概率.
- 通过回归分析,使用以下变量预测了日志概率:查可用性/补偿,孕产妇年龄,人均国民总收入 (GNI) 和国家效应.
- 使用强大的标准误差和模型验证的最小平方回归.
主要成果:
- 从没有查到可用和报销的血清查时,观察到DS降低百分比的显著增加 (OR=3.24, p=0.0001).
- 政策的转变可以使DS的减少率从5%上升到15%,从25%上升到52%,从50%上升到76%.
- 较高的孕产妇年龄和人均国民收入与更高的儿童死亡率有关.
结论:
- 扩大产前查和补偿政策显然可以减少患有唐氏综合征的活产.
- 宏观经济因素,包括国民收入,对疾病查计划的有效性起到作用.
- 旨在增加产前查的政策干预措施可以减少患有DS的活产.
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