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Preterm birth and mortality in adulthood: a systematic review.
Journal of Perinatology ( IF 2.9 ) Pub Date : 2019-11-25 , DOI: 10.1038/s41372-019-0563-y
Casey Crump 1
Affiliation  

Preterm birth (gestational age < 37 weeks) has a worldwide prevalence of nearly 11%, and >95% of preterm infants who receive modern neonatal and pediatric care now survive into adulthood. However, improved early survival has been accompanied by long-term increased risks of various chronic disorders, prompting investigations to determine whether preterm birth leads to higher mortality risks in adulthood. A systematic review identified eight studies with a total of 6,594,424 participants that assessed gestational age at birth in relation to all-cause or cause-specific mortality at any ages ≥18 years. All six studies that included persons born in 1967 or later reported positive associations between preterm birth and all-cause mortality in adulthood (attained ages, 18-45 years). Most adjusted relative risks ranged from 1.2 to 1.6 for preterm birth, 1.1 to 1.2 for early term birth (37-38 weeks), and 1.9 to 4.0 for extremely preterm birth (22-27 weeks), compared with full-term birth (variably defined but including 39-41 weeks). These findings appeared independent of sociodemographic, perinatal, and maternal factors (all studies), and unmeasured shared familial factors in co-sibling analyses (assessed in four studies). Four of these studies also explored cause-specific mortality and reported associations with multiple causes, including respiratory, cardiovascular, endocrine, and neurological. Two smaller studies based on an earlier cohort born in 1915-1929 found no clear association with all-cause mortality but positive associations with selected cause-specific mortality. The overall evidence indicates that premature birth during the past 50 years is associated with modestly increased mortality in early to mid-adulthood.

中文翻译:

早产和成年期死亡率:系统评价。

早产(胎龄 < 37 周)在世界范围内的患病率接近 11%,并且现在接受现代新生儿和儿科护理的早产儿中有超过 95% 能活到成年。然而,早期存活率的提高伴随着各种慢性疾病风险的长期增加,促使调查以确定早产是否会导致成年期更高的死亡风险。一项系统评价确定了八项研究,共有 6,594,424 名参与者,这些研究评估了出生胎龄与 18 岁以上任何年龄的全因或特定原因死亡率之间的关系。包括 1967 年或以后出生的人在内的所有六项研究都报告了早产与成年期全因死亡率(18-45 岁)之间的正相关关系。大多数调整后的相对风险范围为 1.2 到 1。6 为早产,1.1 至 1.2 为早产(37-38 周),1.9 至 4.0 为极早产(22-27 周),与足月分娩(不同定义但包括 39-41 周)相比. 这些发现似乎独立于社会人口学、围产期和母体因素(所有研究),以及兄弟姐妹分析中未测量的共享家族因素(在四项研究中评估)。其中四项研究还探讨了特定原因的死亡率,并报告了与多种原因的关联,包括呼吸、心血管、内分泌和神经系统。基于 1915-1929 年出生的早期队列的两项较小的研究发现与全因死亡率没有明确关联,但与特定原因死亡率呈正相关。
更新日期:2019-11-26
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