获得产妇护理和婴儿死亡率
Ripley Lucas1, Taylor Thames1,2, Jazmin F Chestnut1
1Perinatal Data Center, March of Dimes, Arlington, Virginia.
JAMA network open
|November 11, 2025
概括
在没有获得产妇护理的地区,婴儿死亡风险更高. 这种增加的风险在所有婴儿中观察到,特别是非西班牙裔白人婴儿中,突出了母亲获得医疗保健的差异.
科学领域:
- 公共卫生 公共卫生
- 孕产妇和儿童的健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 婴儿死亡率是人口健康的一个关键指标.
- 在某些县,获得产妇护理的限制可能会影响婴儿存活率.
- 了解这些关联对于有针对性的公共卫生干预至关重要.
研究的目的:
- 评估母亲居住在有限获得产妇护理的县和婴儿死亡率之间的联系.
- 通过不同母亲种族/种族群体和婴儿死亡时间 (新生儿与新生儿后) 来检查这些关联.
主要方法:
- 使用美国出生和婴儿死亡记录 (2017-2021) 的横截面研究.
- 根据设施可用性,临床医生比例和保险状况,按县分类的产妇护理准入.
- 多变量日志双项回归用于分析护理准入与婴儿死亡率之间的关联,并进行分层分析.
主要成果:
- 随着产妇护理的减少,婴儿死亡率增加.
- 与完全接入县的婴儿相比,在没有接入县的婴儿的死亡风险明显更高 (aRR,1.14).
- 这种增加的风险在非西班牙裔白人婴儿中是显著的 (aRR, 1.20) 并在新生儿和新生儿后期间观察到.
结论:
- 限定的产妇护理机会与增加婴儿死亡风险有关.
- 非西班牙裔白人婴儿的风险差异似乎更明显,这表明其他群体的潜在未测量的障碍.
- 调查结果强调需要解决产妇护理的地理差异,以改善婴儿健康结果.
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