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在不利的出生结果中,教育不平等的规模和人口负担
Anton Schreuder1,2, David van Klaveren3, Richard M K van Dijk4
1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000, CA, Netherlands. antoniusschreuder@gmail.com.
Scientific reports
|February 11, 2026
概括
母亲教育对荷兰的出生结果产生重大影响,教育水平较低与较高的不良事件率有关. 解决整个教育梯度,而不仅仅是最高风险,提供了最大的人口健康收益.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- 不利的出生结果是一个重大的公共卫生问题.
- 母亲教育是健康的关键社会决定因素,有可能影响怀孕和分娩的结果.
- 了解出生结果的教育不平等程度对于有针对性的干预至关重要.
研究的目的:
- 量化母亲教育水平与荷兰不良分娩结果之间的关联.
- 估计人口负担和由于教育不平等而导致的不良分娩结果的可归因部分.
- 通过确定最具影响力的教育群体进行干预,为公共卫生战略提供信息.
主要方法:
- 使用荷兰 (2016-2019) 国家注册表数据进行的回顾性队列研究.
- 包括单独分娩 (妊娠年龄≥24周或出生体重≥500克).
- 分析了五个母亲教育类别的不良分娩结果,计算率比率和人口归因分数.
主要成果:
- 大约六分之一的荷兰分娩经历了不良结果.
- 在受教育程度最高和最低的群体 (RR分别为2.94和2.25) 之间观察到死胎和新生儿死亡率的显著不平等.
- 在早产,怀孕年龄相对小,低Apgar分数,NICU入院和先天异常 (RR 1.32-1.77) 方面发现了中等程度的不平等.
- 将死亡率降低到受教育程度最高的群体水平,可能会使死产率降低35%,新生儿死亡率降低27%.
- 中等教育群体对人口不平等负担做出了最大的贡献.
结论:
- 在荷兰,教育程度与不良出生结果有很强的关联.
- 显著的人口归因分数突出了教育不平等对死胎和新生儿死亡率的影响.
- 针对整个教育健康梯度的预防策略,而不是仅仅关注风险最高的个体,可能会产生最大的人口健康收益.
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