出生缺陷的婴儿中母亲的种族和种族和死亡率差异:德克萨斯州全州的队列分析
A J Agopian1, Renata H Benjamin1, Omobola O Oluwafemi1
1Department of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX.
The Journal of pediatrics
|October 31, 2025
概括
非西班牙裔黑人婴儿患有出生缺陷的新生儿死亡率高于非西班牙裔白人婴儿. 这些差异凸显出需要解决潜在的社会经济和健康劣势,以减少婴儿死亡率.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 围产期健康 围产期健康
背景情况:
- 新生儿后死亡率 (PNM) 仍然是一个重大的公共卫生问题.
- 婴儿死亡率存在跨种族和种族群体的差异.
- 了解出生缺陷的婴儿中的这些差异对于有针对性的干预至关重要.
研究的目的:
- 为了检查与孤立的出生缺陷的婴儿在产后死亡率 (PNM) 的差异.
- 根据母亲的种族和种族来比较PNM率:西班牙裔,非西班牙裔 (NH) 黑人和德克萨斯州的NH白人.
- 确定导致婴儿死亡率观察到的种族和民族差异的因素.
主要方法:
- 德克萨斯州出生缺陷登记 (1999-2017) 对具有孤立出生缺陷的婴儿进行分析.
- 考克斯回归模型用于评估母亲的种族/种族与PNM之间的关联 (在28-364天之间死亡).
- 在教育水平,年龄组之间进行的分层分析,并根据多个共变量进行调整,包括妊娠年龄和出生体重.
主要成果:
- 与NH白人妇女相比,NH黑人妇女生下的婴儿患PNM的风险是NH白人妇女的1.94倍.
- 在调整妊娠年龄,出生体重和其他共变量后,这种关联仍然存在.
- 在特定的子组中观察到更高的PNM风险,包括25岁以上的NH黑人母亲出生的正常出生体重的婴儿 (HR:3.37),拥有私人保险 (HR: 3.37).
- 在西班牙裔和NH白人母亲之间发现了很少的PNM显著差异.
结论:
- 在患有出生缺陷的婴儿中,PNM存在显著的种族差异,特别是在NH黑人和NH白人群体之间.
- 这些差异很可能受到社会经济,情境,心理社会和与健康有关的不利因素的复杂相互作用的影响.
- 对根本原因的进一步研究对于开发旨在减少这些差异和提高婴儿存活率的有效干预措施至关重要.
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