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首页> 外文期刊>Birth defects research, Part A. Clinical and molecular teratology >Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal race/ethnicity.
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Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal race/ethnicity.

机译：有先天缺陷的婴儿的死亡率：出生时体重，胎龄和孕产妇种族/种族的共同影响。

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摘要

BACKGROUND: We examined the separate and joint effects of gestational age, size at birth and maternal race/ethnicity on early childhood survival among 48,391 singleton infants with major birth defects. METHODS: Texas Birth Defects Registry data were linked to death records and the National Death Index to ascertain deaths. Gestational age categories were preterm or term birth; size at birth included small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Kaplan-Meier survival estimates were calculated, and Cox-proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) to determine risk of death after adjusting for covariates. RESULTS: Overall, relative to non-Hispanic (NH) -whites, NH-blacks, and Hispanics had a 51 and 10% greater risk of death during early childhood, respectively. Compared to NH-whites born term and AGA (survival = 97%), Hispanic children born SGA and preterm had the greatest risk of death (HR(a) = 6.1; 95% CI, 5.2, 7.2) and the lowest early childhood survival (76%), followed by SGA preterm NH-blacks (HR(a) = 4.8; 95% CI, 3.6, 6.5; survival = 81%) and SGA preterm NH-whites (HR(a) = 4.5; 95% CI, 3.7, 5.6; survival = 83%). Children born LGA at term had no increased risk of mortality regardless of maternal race/ethnicity. CONCLUSIONS: The joint effect of gestational age and size at birth had greatest impact on childhood mortality. Additional population based studies are needed to better understand causes of racial/ethnic disparities in mortality among children with birth defects.
机译：摘要背景：我们研究了48391名有严重先天缺陷的单身婴儿，其胎龄，出生时的大小以及母体种族/民族对儿童早期生存的单独和共同影响。方法：将德克萨斯州出生缺陷登记处的数据与死亡记录和国家死亡指数联系起来，以确定死亡人数。妊娠年龄类别为早产或足月;出生时的大小包括胎龄（SGA），胎龄（AGA）和胎龄（LGA）大。计算Kaplan-Meier生存估计值，并使用Cox比例风险模型计算风险比（HR）和95％置信区间（CI），以确定调整协变量后的死亡风险。结果：总体而言，相对于非西班牙裔（NH）白人，NH黑人和西班牙裔，儿童早期死亡的风险分别高51％和10％。与出生于NH白人的足月和AGA（存活率= 97％）相比，出生于SGA和早产的西班牙裔儿童的死亡风险最高（HR（a）= 6.1; 95％CI，5.2，7.2），最低的儿童早期存活率（76％），其次是SGA早熟NH-黑人（HR（a）= 4.8; 95％CI，3.6，6.5;生存率= 81％）和SGA早熟NH-whites（HR（a）= 4.5; 95％CI ，3.7、5.6;生存率= 83％）。不论母亲种族/民族，足月出生的LGA患儿的死亡风险均没有增加。结论：胎龄和出生时大小的联合影响对儿童死亡率具有最大影响。需要进行更多的基于人口的研究，以更好地了解出生缺陷儿童的种族/族裔死亡率差异的原因。

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