Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010.
Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010.
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DOI：
10.1038/pr.2013.204
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发表时间：
2013-12
影响因子：
3.6
通讯作者：
Lawn, Joy E.
中科院分区：
文献类型：
--
作者：
Blencowe, Hannah;Lee, Anne C. C.;Cousens, Simon;Bahalim, Adil;Narwal, Rajesh;Zhong, Nanbert;Chous, Doris;Say, Lale;Modi, Neena;Katz, Joanne;Vos, Theo;Marlow, Neil;Lawn, Joy E.
2010年，全世界估计有1500万早产儿（妊娠期<37周）。幸存者面临不良后果的风险，全球和区域一级的负担估计对于确定优先事项至关重要。系统评价和荟萃分析是根据护理水平来估计存活早产儿长期神经发育障碍的风险。2010年，一个室室模型被用来估计早产后受损的新生儿后幸存者的数量。使用一个单独的模型（DisMod-MR）来估计2010年全球疾病负担研究的残疾生活年数（YLDs）。伤残调整生命年（DALYs）计算为伤残调整生命年（YLDs）和丧失生命年（YLLs）之和。2010年，估计有1300万早产儿活过了第一个月。其中，345,000人（2.7%，不确定范围：269,000-420,000）估计有中度或重度神经发育障碍，另有567,000人（4.4%,445,000-732,000）估计有轻度神经发育障碍。更多的人有特殊的学习或行为障碍，或身体或精神健康状况下降。负担最重的地方可用数据最少。早产造成7700万残疾调整生命年，占全球总数的3.1%，其中只有300万残疾调整生命年。大多数早产儿（约90%）没有神经发育障碍。制定预防早产的有效手段应该是一项较长期的优先事项，但通过提高护理的覆盖面和质量，可以立即大大减轻负担。改善新生儿护理将降低死亡率，特别是在低收入国家，并可能减少幸存者的损害，特别是在中等收入环境中。
In 2010, there were an estimated 15 million preterm births worldwide (<37 wk gestation). Survivors are at risk of adverse outcomes, and burden estimation at global and regional levels is critical for priority setting. Systematic reviews and meta-analyses were undertaken to estimate the risk of long-term neurodevelopmental impairment for surviving preterm babies according to the level of care. A compartmental model was used to estimate the number of impaired postneonatal survivors following preterm birth in 2010. A separate model (DisMod-MR) was used to estimate years lived with disability (YLDs) for the global burden of disease 2010 study. Disability adjusted life years (DALYs) were calculated as the sum of YLDs and years of life lost (YLLs). In 2010, there were an estimated 13 million preterm births who survived beyond the first month. Of these, 345,000 (2.7%, uncertainty range: 269,000–420,000) were estimated to have moderate or severe neurodevelopmental impairment, and a further 567,000 (4.4%, (445,000–732,000)) were estimated to have mild neurodevelopmental impairment. Many more have specific learning or behavioral impairments or reduced physical or mental health. Fewest data are available where the burden is heaviest. Preterm birth was responsible for 77 million DALYs, 3.1% of the global total, of which only 3 million were YLDs. Most preterm births (>90%) survive without neurodevelopmental impairment. Developing effective means of prevention of preterm birth should be a longer term priority, but major burden reduction could be made immediately with improved coverage and quality of care. Improved newborn care would reduce mortality, especially in low-income countries and is likely to reduce impairment in survivors, particularly in middle-income settings.
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