Etiology of low-birthweight birth: a population-based study.
Etiology of low-birthweight birth: a population-based study.
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DOI：
10.1006/pmed.1994.1136
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发表时间：
1994-11
影响因子：
5.1
通讯作者：
M. Moore;R. Michielutte;P. Meis;J. Ernest;H. Wells;P. Buescher
中科院分区：
文献类型：
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作者：
M. Moore;R. Michielutte;P. Meis;J. Ernest;H. Wells;P. Buescher
早产和低出生体重儿仍然是美国婴儿死亡率的主要相关因素。认识到这些分娩是由不同的近端病因引起的，对于制定针对每个病因组的预防策略至关重要。方法使用由北卡罗来纳州健康和环境统计中心提供的生命统计数据磁带，确定了20个县的母亲，她们分娩的婴儿出生体重在1磅到5磅8盎司之间。回顾了4，754名妇女的孕产妇医院记录，以获取有关产前和分娩事件的数据。两名围产科医生将出生分为四个近端病因组：足月低出生体重、医学指征早产、早产胎膜早破和特发性早产。出生证明和医院记录的信息被合并，以提供一个扩大的数据集。结果种族、年龄、教育程度和婚姻状况与不同的近端病因模式相关。黑人妇女和年轻妇女中所有病因的比率都较高;然而，出生体重不足的绝对数量在白色妇女中最高。特发性早产在黑人妇女中最高，随着年龄的增加而下降;早产的医学指征随着年龄的增加而增加。结论按病因组对低出生体重儿的分类为临床医生和研究人员提供了有价值的见解。将通过确定病因来加强以LBW和/或早产为结局变量的研究。多种预防策略应针对不同的病因组。
BACKGROUND Preterm and low-birthweight births remain the major correlates of infant mortality in the United States. The recognition that these births result from varying proximal etiologies is essential to the development of preventive strategies specific to each etiologic group. METHODS Using vital statistics data tapes provided by the North Carolina Center for Health and Environmental Statistics, mothers in 20 counties who delivered infants with birthweights between 1 pound and 5 pounds, 8 ounces were identified. Maternal hospital records of 4,754 women were reviewed for data about prenatal and intrapartal events. Two perinatologists classified births into four proximal etiology groups: term-lowbirthweight, medically indicated preterm birth, preterm premature rupture of membranes, and idiopathic preterm birth. Information from birth certificate and hospital records was merged to provide an expanded data set. RESULTS Race, age, education, and marital status are associated with different patterns of proximal etiology. Rates were higher for all etiologies in black women and in young women; however, the absolute number of LBW births was highest among white women. Idiopathic preterm birth was highest in black women and decreased as age increased; medical indications for preterm birth increased with increasing age. CONCLUSIONS Classification of LBW births by etiologic group provides insights of value to both clinicians and researchers. Studies in which LBW and/or preterm birth are the outcome variables will be enhanced by identifying etiology. Multiple preventive strategies should address varying etiologic groups.