Gestational age at birth and mortality from infancy into mid-adulthood: a national cohort study
Gestational age at birth and mortality from infancy into mid-adulthood: a national cohort study
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DOI：
10.1016/s2352-4642(19)30108-7
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发表时间：
2019-06-01
影响因子：
36.4
通讯作者：
Sundquist, Kristina
中科院分区：
文献类型：
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作者：
Crump, Casey;Sundquist, Jan;Sundquist, Kristina
大约40年前，早产治疗的突破性进展使一代早产幸存者现在达到了成年中期。了解他们的健康后遗症对于指导他们的长期护理至关重要。我们做了一项研究，以检查早产与死亡率到中年。方法对1973年至2015年期间瑞典所有4 296 814例单胎活产婴儿进行了一项全国性队列研究，随访死亡率至2017年12月31日（最大年龄45岁）。考克斯回归被用来检查出生时的胎龄与全因和原因特异性死亡率，并cossibling分析评估潜在的混淆共享的家族（遗传或环境）factors.Findings在103.5万人年的后续行动，43916（1.0%）死亡的报道。出生时的生育年龄与从婴儿期到中年期的死亡率呈负相关。相对于足月分娩（39-41周），与出生时胎龄相关的死亡率的校正风险比为：66.14极早产儿（95% CI 63.09-69.34）（22-27周），8.67（8.32-9.03）对于极早产儿（28-33周），2.61（2.52-2.71）晚期早产（34-36周）和1.34（1.30-1.37）早期（37-38周），从出生到45岁;和2.04（0.92-4.55）极早产儿，1.48（1.17-1.87），晚期早产1.22（1.07-1.39），早期足月1.16（1.08-1.25），年龄30-45岁。早产占男性死亡人数比女性多（加性相互作用p
Background Breakthroughs in the treatment of preterm birth approximately 40 years ago have enabled a generation of preterm survivors to now reach mid-adulthood. Understanding their health sequelae is essential for guiding their long-term care. We did a study to examine preterm birth in relation to mortality into mid-adulthood.Methods A national cohort study was done of all 4 296 814 singleton livebirths in Sweden between 1973 and 2015, who were followed up for mortality through Dec 31, 2017 (maximum age 45 years). Cox regression was used to examine gestational age at birth in relation to all-cause and cause-specific mortality, and cosibling analyses assessed for potential confounding by shared familial (genetic or environmental) factors.Findings In 103.5 million person-years of follow-up, 43 916 (1.0%) deaths were reported. Gestational age at birth was inversely associated with mortality from infancy to mid-adulthood. Relative to full-term birth (39-41 weeks), the adjusted hazard ratios for mortality associated with gestational age at birth were: 66.14 (95% CI 63.09-69.34) for extremely preterm (22-27 weeks), 8.67 (8.32-9.03) for very preterm (28-33 weeks), 2.61 (2.52-2.71) for late preterm (34-36 weeks), and 1.34 (1.30-1.37) for early term (37-38 weeks), from birth to age 45 years; and 2.04 (0.92-4.55) for extremely preterm, 1.48 (1.17-1.87) for very preterm, 1.22 (1.07-1.39) for late preterm, and 1.16 (1.08-1.25) for early term, at ages 30-45 years. Preterm birth accounted for more deaths among males than females (additive interaction p