The epidemiology of adverse pregnancy outcomes: An overview
The epidemiology of adverse pregnancy outcomes: An overview
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DOI：
10.1093/jn/133.5.1592s
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发表时间：
2003-05-01
影响因子：
4.2
通讯作者：
Kramer, MS
中科院分区：
文献类型：
--
作者：
Kramer, MS
本文概述了不良妊娠结局的发生、病因和时间趋势，突出了发达国家和发展中国家在孕产妇死亡率、婴儿死亡率、死产和低出生体重方面的差异。发展中国家低出生体重率较高主要是由于宫内生长受限，而不是早产。许多过度的宫内生长受限是由母亲身材矮小、孕前体重指数低和妊娠期体重增加低（由于能量摄入低）引起的。微量营养素摄入量没有重要的贡献，也没有不同的胎儿生长轨迹被证明反映暴露于营养或其他病因因素的时间。在发达国家和发展中国家，婴儿死亡率都随着时间的推移而大幅度下降，尽管出生体重不足的情况没有减少（甚至有所增加）。一些发达国家报告称，足月出生的婴儿的胎儿生长暂时增加，死胎率降低，神经管缺陷得到预防。然而，在了解早产的病因和预防方面还需要更多的进展。
This paper provides an overview of the occurrence, etiology and temporal trends of adverse pregnancy outcomes, Disparities between developed and developing countries are highlighted for maternal mortality, infant mortality, stillbirth and low birth weight. The higher rate of low birth weight in developing countries is primarily due to intrauterine growth restriction rather than preterm birth. Much of the excess intrauterine growth restriction is caused by short maternal stature, low prepregnancy body mass index and low gestational weight gain (due to low energy intake). No important contribution has been established for micronutrient intake, nor have different fetal growth trajectories been demonstrated to reflect the timing of exposure to nutritional or other etiologic factors. Infant mortality has declined substantially over time both in developed and developing countries despite no decline (and even an increase) in low birth weight. Several developed countries have reported a temporal increase in fetal growth in infants born at term, a reduction in stillbirth rates and prevention of neural tube defects. More progress is required, however, in understanding the etiology and prevention of preterm birth.