Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010.
Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010.
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DOI：
10.1371/journal.pone.0160766
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Luo ZC
中科院分区：
文献类型：
--
作者：
Xiao L;Zhang DL;Torrie J;Auger N;McHugh NG;Luo ZC
在魁北克出生的克里人的特点是巨大儿的发病率最高的报告（~35%）在世界上。目前还不清楚克里族出生的婴儿围产期和婴儿死亡率是否比其他第一民族相对于魁北克非土著出生的婴儿更高的风险，以及巨大儿是否可能有关。这是一项基于人口的回顾性出生队列研究，使用链接的出生婴儿死亡数据库，对1996-2010年魁北克克里族（n = 5，340）、其他原住民（n = 10，810）和非土著（n = 229，960）社区的母亲进行单胎分娩。社区类型是通过居民区邮政编码和城市名称确定的。主要结局为围产期和婴儿死亡率。巨大儿（胎龄出生体重>第90百分位数）在克里族（38.0%）和其他原住民（21.9%）社区比非土著社区（9.4%）更常见。克里族和其他原住民与非土著社区相比，围产期死亡率分别高出1.52倍（95%置信区间1.17，1.98）和1.34倍（1.10，1.64），婴儿死亡率分别高出2.27倍（1.71，3.02）和1.49倍（1.16，1.91）。克里族社区围产期和婴儿死亡的风险升高在调整母亲特征（年龄、教育、婚姻状况、产次）后减弱，但在进一步调整出生体重（胎龄小、适当或大）后变得更大。在魁北克，克里社区的围产期死亡率和婴儿死亡率比其他原住民社区的风险更高。巨大儿的高患病率并不能解释克里社区围产期和婴儿死亡率升高的风险。
Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996–2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities.