US birth weight/gestational age-specific neonatal mortality: 1995-1997 rates for whites, Hispanics, and blacks
US birth weight/gestational age-specific neonatal mortality: 1995-1997 rates for whites, Hispanics, and blacks
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DOI：
10.1542/peds.111.1.e61
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发表时间：
2003-01-01
期刊：
影响因子：
8
通讯作者：
Mor, J
中科院分区：
文献类型：
--
作者：
Alexander, GR;Kogan, M;Mor, J
Objective.近年来，新生儿存活率的提高在极低出生体重儿、早产儿和低出生体重儿（LBW）中最为明显。自1980年代初以来，新生儿存活率的大部分改善似乎是出生体重特定死亡率下降的结果，这发生在早产率和出生体重不足率上升的时期。尽管新生儿死亡率的下降在美国得到了广泛宣传，但研究表明，临床医生可能仍然低估了出生过早或过小的婴儿的生存机会，并可能高估了严重残疾的可能性。因此，临床医生可能有当前和需要的种族和种族特异性估计的新生儿早期生存的“机会”，我们检查了出生体重/胎龄特异性新生儿死亡率为3个最大的种族/种族群体在美国：非西班牙裔白人，西班牙裔和非西班牙裔黑人。出生体重和胎龄特异性死亡率的显著种族差异早已被认识到，并且越来越多的人对妊娠结局中持续和不断增加的种族差异表示担忧。本研究的目的是提供一个最新的国家参考出生体重/胎龄特异性新生儿死亡率，供临床医生在护理决策和与父母讨论时使用。国家卫生统计中心1995-1997年的活产婴儿死亡队列文件被用于本研究。选择报告母亲种族/人种为非西班牙裔白色、非西班牙裔黑人或西班牙裔（n = 10 610 715）的美国居民母亲的单胎活产进行分析。出生体重/胎龄特异性新生儿死亡率计算使用250 g/2周的间隔为每个种族/种族组。白人、西班牙裔和黑人的总体新生儿死亡率分别为每1000例活产3.24、3.45和8.16例新生儿死亡，
Objective. In recent years, gains in neonatal survival have been most evident among very low birth weight, preterm, and low birth weight (LBW) infants. Most of the improvement in neonatal survival since the early 1980s seems to be the consequence of decreasing birth weight-specific mortality rates, which occurred during a period of increasing preterm and LBW rates. Although the decline in neonatal mortality has been widely publicized in the United States, research suggests that clinicians may still underestimate the chances of survival of an infant who is born too early or too small and may overestimate the eventuality of serious disability. So that clinicians may have current and needed ethnic- and race-specific estimates of the "chances" of early survival for newborn infants, we examined birth weight/gestational age-specific neonatal mortality rates for the 3 largest ethnic/racial groups in the United States: non-Hispanic whites, Hispanics, and non-Hispanic blacks. Marked racial variation in birth weight and gestational age-specific mortality has long been recognized, and growing concerns have been raised about ongoing and increasing racial disparities in pregnancy outcomes. Our purpose for this investigation was to provide an up-to-date national reference for birth weight/gestational age-specific neonatal mortality rates for use by clinicians in care decision making and discussions with parents.Methods. The National Center for Health Statistics linked live birth-infant death cohort files for 1995-1997 were used for this study. Singleton live births to US resident mothers with a reported maternal ethnicity/race of non-Hispanic white, non-Hispanic black, or Hispanic (n = 10 610 715) were selected for analysis. Birth weight/gestational age-specific neonatal mortality rates were calculated using 250 g/2-week intervals for each ethnic/racial group.Results. The overall neonatal mortality rates for whites, Hispanics, and blacks were 3.24, 3.45, and 8.16 neonatal deaths per 1000 live births, and the proportion of births