Trends of preterm birth and low birth weight in Japan a one hospital-based study 英文参考文献.docVIP

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Trends of preterm birth and low birth weight in Japan a one hospital-based study 英文参考文献.doc

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Trends of preterm birth and low birth weight in Japan a one hospital-based study 英文参考文献

Yorifujietal.BMCPregnancyandChildbirth2012,12:162 /1471-2393/12/162 RESEARCH ARTICLE OpenAccess Trendsofpretermbirthandlowbirthweightin Japan:aonehospital-basedstudy TakashiYorifuji1*,HirooNaruse2,SaoriKashima3,TakeshiMurakoshi2,TsuguhikoKato1,SachikoInoue4,5, HiroyukiDoi4andIchiroKawachi5 Abstract Background:Theproportionsofpretermbirth(PTB,ie.,deliveredbefore37gestationalweeks)andlowbirth weight(LBW,ie.,birthweightlessthan2500gatdelivery)havebeenrisingindevelopedcountries.Wesoughtto examinethefactorscontributingtotheriseinJapan,withparticularfocusontheeffectsofobstetricinterventions. Methods:WeusedadatabasemaintainedbyonelargeregionalhospitalinShizuoka,Japan.Werestrictedthe analysistomotherswhodeliveredlivesingletonbirthsfrom1997to2010(n=19,221).Weassessedthetemporal trendsinPTBandLBW,thendividedthestudyperiodintofourintervalsandcomparedtheproportionsofPTBand LBW.Wealsocomparedthenewborns’outcomesbetweentheintervals. Results:PTB,inparticularmedicallyindicatedPTB,increasedconsiderably.Theincreasewaslargelyexplainedby changesincaesareansections.Theneonataloutcomesdidnotworsen,andinsteadtheApgarscoresand proportionsrequiringneonatalintensivecareunit(NICU)admissionimproved.Inparticular,therisksofNICU admissionintheintervalfrom2007to2010weredecreasedamongallbirths[oddsratio(OR):0.84;95%confidence interval(CI):0.75,0.95]andmedicallyindicatedbirths(OR:0.44;95%CI:0.29,0.68)comparedwiththeintervalfrom 1997to2000. Conclusions:DespitetheincreasesinPTBaswellasLBW,thepresentstudysuggestsbenefitsofobstetric interventions.RatherthansimplecategorizationofPTBorLBW,indicatorssuchasperinatalmortalityorother outcomesmaybemoreappropriateforevaluationofperinatalhealthindevelopedcountries. Keywords:Caesareansection,Lowbirthweight,Pregnancy,Pretermbirth,Reproductivehealth Background preterm) has been increasing [5,6]. Although the rise of Preterm birth (PTB, ie. delivered before 37 gestational PTB may be partly explained by changes in sociodemo- weeks) and low birth weight (LBW, ie. b