Mortality of late-preterm (near-term) newborns in Utah

Mortality of late-preterm (near-term) newborns in Utah
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DOI：
10.1542/peds.2006-2486
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发表时间：
2007-03-01
期刊：
PEDIATRICS
影响因子：
8
通讯作者：
Stoddard, Gregory
Stoddard, Gregory
中科院分区：
医学2区
文献类型：
--
作者：
Young, Paul C.;Glasgow, Tiffany S.;Stoddard, Gregory

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目标.这项工作的目的是确定死亡的相对风险和死亡的原因和年龄的晚期早产儿（胎龄34 - 36周）相比，那些在足月出生。我们回顾了1999年至2004年间出生于犹他州的婴儿的出生和死亡证明数据。我们计算了34 - 42周每个每周估计胎龄队列的早期新生儿（第一周）、新生儿（前28天）和婴儿（第一年）死亡率，并以40周为参考，计算了每个队列的风险比。将死亡原因分为8类，并对近期和足月新生儿进行比较。测量了粗死亡率和各种原因死亡的风险比以及婴儿死于除出生缺陷以外的各种原因的风险比。出生缺陷是足月儿和晚期早产儿死亡的最常见原因。在排除了出生缺陷死亡的新生儿后，晚期早产儿的死亡率仍然显著较高。与足月出生的新生儿相比，晚期早产（近足月）新生儿的死亡率明显更高.估计胎龄的每周增加与死亡风险的降低有关。出生缺陷是晚期早产儿死亡的主要原因，但并不能完全解释他们较高的死亡风险。
OBJECTIVES. The purpose of this work was to determine the relative risk for mortality and the causes and ages of death for late- preterm newborns ( gestational age of 34 - 36 weeks) compared with those born at term.METHODS. We reviewed data from birth and death certificates of infants born in Utah between 1999 and 2004. We calculated early neonatal ( first week), neonatal ( first 28 days), and infant ( first year) mortality rates for each weekly estimated gestational age cohort from 34 to 42 weeks and, using 40 weeks as the reference, risk ratios for each cohort. Causes of death were grouped into 8 categories and compared for near term and term newborns. Crude mortality rates and risk ratios for death from all causes and for infants dying of all causes other than birth defects were measured.RESULTS. Birth defects were the single- most common cause of death for both term and late- preterm newborns. Mortality rates for late- preterm newborns remained significantly higher after excluding those who died of birth defects from the comparisons.CONCLUSIONS. Compared with those born at term, late- preterm ( near- term) newborns have significantly higher mortality rates. Each weekly increase in estimated gestational age is associated with a decreasing risk of death. Birth defects are the leading cause of death among late- preterm newborns but do not entirely account for their higher risk of death.