Preterm birth risk at high altitude in Peru.
Preterm birth risk at high altitude in Peru.
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秘鲁高海拔地区的早产风险。
DOI：
10.1016/j.ajog.2014.08.024
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发表时间：
2015-02
影响因子：
9.8
通讯作者：
Ludmir, Jack
中科院分区：
文献类型：
--
作者：
Levine, Lisa D.;Gonzales, Gustavo F.;Tapia, Vilma L.;Gasco, Manuel;Sammel, Mary D.;Srinivas, Sindhu K.;Ludmir, Jack
高海拔与多种不良妊娠结局有关，包括先兆子痫和死胎。较小规模的研究显示，关于高海拔地区与早产（PTB）之间关系的数据相互矛盾。本研究的目的是评估海拔高度与肺结核之间的关系。利用围产期信息系统的数据进行了一项回顾性队列研究，其中包括2000-2010年秘鲁43家医院的分娩情况。海拔高度分为低海拔（0 ~ 1999m）、中海拔（2000 ~ 2900m）和高海拔（3000 ~ 4340m）。主要结局是PTB（分娩<37周）。次要结局为剖宫产和小胎龄（SGA）。分娩<23周不包括在数据库中。使用卡方分析比较分类变量，使用逻辑回归计算优势比和混杂因素的控制。采用广义估计方程对医院进行聚类。其中包括550166名女性（68%为低海拔，15%为中等海拔，17%为高海拔）。3个海拔地区PTB总体发病率为5.9%，差异无统计学意义（5.6%、6.2%、6.8%,p=0.13）。剖宫产率差异有统计学意义（28.0、26.6、20.6%,p<0.001），经混杂因素调整后，高海拔地区剖宫产率比低海拔地区降低34% （aOR为0.66[0.51-0.85]）。SGA存在差异（3.3,3.6,5.0%,p=0.02），经混杂因素调整后，高海拔与低海拔的风险增加51% （aOR为1.49[1.14-1.93]）。高海拔与肺结核无关。高海拔地区剖宫产率降低，SGA率升高。
High altitude has been implicated in a variety of adverse pregnancy outcomes including preeclampsia and stillbirth. Smaller studies show conflicting data on the association between high altitude and preterm birth (PTB). The objective of this study was to assess the association between altitude and PTB. A retrospective cohort study was performed using data from the Perinatal Information System which includes deliveries from 43 hospitals in Peru from 2000–2010. Altitude was classified into: low (0–1999m), moderate (2000–2900m), and high (3000–4340m). The primary outcome was PTB (delivery <37 weeks). Secondary outcomes were cesarean delivery and small for gestational age (SGA). Deliveries <23 weeks are not included in the database. Chi-square analyses were performed to compare categorical variables and logistic regression was used to calculate odds ratios and control for confounders. Clustering by hospital was accounted for using generalized estimating equations. 550,166 women were included (68% low, 15% moderate, 17% high altitude). The overall PTB rate was 5.9% with no difference in PTB rate among the 3 altitudes (5.6, 6.2, 6.8%, p=0.13). There was a significant difference in cesarean rates (28.0, 26.6, 20.6%, p<0.001) with a 34% decreased risk at high vs. low altitude adjusted for confounders (aOR 0.66 [0.51–0.85]). There was a difference in SGA (3.3, 3.6, 5.0%, p=0.02) with a 51% increased risk at high vs. low altitude adjusted for confounders (aOR 1.49 [1.14–1.93]). High altitude is not associated with PTB. At high altitude, the cesarean rate was reduced and SGA rate was increased.
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影响因子：
7.2
作者：
Esplin, Michael S.;O'Brien, Elizabeth;Varner, Michael W.
通讯作者：
Varner, Michael W.
影响因子：
4.2
作者：
Rasmussen, KM
通讯作者：
Rasmussen, KM
影响因子：
120.7
作者：
UNGER, C;WEISER, JK;MOORE, LG
通讯作者：
MOORE, LG
影响因子：
8
作者：
Hamilton, Brady E.;Hoyert, Donna L.;Guyer, Bernard
通讯作者：
Guyer, Bernard
DOI：
10.1016/0020-7292(96)02673-2
发表时间：
1996-07-01
影响因子：
3.8
作者：
Ali, KZM;Ali, ME;Khalid, MEM
通讯作者：
Khalid, MEM