Ruofan Yao, Jordan Rossi, Hoang Yen Nguyen, Kriti Vedhanayagam, Neville Tritch, Sergio Karageuzian, Ilish Gedestad, Stephen Contag
{"title":"2015 - 2020年美国与孕产妇肥胖相关的围产期死亡率趋势。","authors":"Ruofan Yao, Jordan Rossi, Hoang Yen Nguyen, Kriti Vedhanayagam, Neville Tritch, Sergio Karageuzian, Ilish Gedestad, Stephen Contag","doi":"10.1055/a-2511-8759","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong> Obesity is associated with an increased risk of stillbirth and neonatal death. Since the publication of A Randomized Trial of Induction Versus Expectant Management (ARRIVE) in 2018, there was an increase in 39-week deliveries. The objective of this study was to evaluate the trends in perinatal mortality by body mass index (BMI) category from 2015 to 2020.</p><p><strong>Study design: </strong> This was a retrospective cohort study of U.S. births between 2015 and 2020. The rates of stillbirths, infant deaths, and perinatal mortality were calculated for each BMI category. Logistic regression models were constructed based on specific outcome rates from 2015 to 2018 to predict the rates in 2019 and 2020. The predicted rates were compared with the actual rates to determine possible deviations due to policy and practice changes that occurred.</p><p><strong>Results: </strong> Between 2015 and 2018, the stillbirth rate increased for ascending BMI categories. Whereas the neonatal death rate decreased for all except the underweight group, the perinatal death rate increased in all except for those with category III obesity. In 2019 the perinatal mortality rate decreased for every BMI category except underweight group. In 2020, the rate of infant deaths increased for all BMI categories compared with the predicted rates. The results were similar after excluding common comorbidities.</p><p><strong>Conclusion: </strong> Perinatal mortality rates improved in 2019, reversing the increasing trend from 2015 to 2018. However, this trend did not persist for some BMI categories in 2020. These findings may suggest a beneficial effect of policy changes since the ARRIVE trial publication and the negative effects from the coronavirus disease 2019 pandemic.</p><p><strong>Key points: </strong>· There was a trend toward decreasing perinatal mortality in 2019 compared with previous years.. · The downward trend in perinatal mortality may be attributed to an increase in 39-week deliveries.. · The downward trend in perinatal mortality did not persist into 2020, likely due to COVID-19..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perinatal Mortality Trend Associated with Maternal Obesity in United States between 2015 and 2020.\",\"authors\":\"Ruofan Yao, Jordan Rossi, Hoang Yen Nguyen, Kriti Vedhanayagam, Neville Tritch, Sergio Karageuzian, Ilish Gedestad, Stephen Contag\",\"doi\":\"10.1055/a-2511-8759\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong> Obesity is associated with an increased risk of stillbirth and neonatal death. Since the publication of A Randomized Trial of Induction Versus Expectant Management (ARRIVE) in 2018, there was an increase in 39-week deliveries. The objective of this study was to evaluate the trends in perinatal mortality by body mass index (BMI) category from 2015 to 2020.</p><p><strong>Study design: </strong> This was a retrospective cohort study of U.S. births between 2015 and 2020. The rates of stillbirths, infant deaths, and perinatal mortality were calculated for each BMI category. Logistic regression models were constructed based on specific outcome rates from 2015 to 2018 to predict the rates in 2019 and 2020. The predicted rates were compared with the actual rates to determine possible deviations due to policy and practice changes that occurred.</p><p><strong>Results: </strong> Between 2015 and 2018, the stillbirth rate increased for ascending BMI categories. Whereas the neonatal death rate decreased for all except the underweight group, the perinatal death rate increased in all except for those with category III obesity. In 2019 the perinatal mortality rate decreased for every BMI category except underweight group. In 2020, the rate of infant deaths increased for all BMI categories compared with the predicted rates. The results were similar after excluding common comorbidities.</p><p><strong>Conclusion: </strong> Perinatal mortality rates improved in 2019, reversing the increasing trend from 2015 to 2018. However, this trend did not persist for some BMI categories in 2020. These findings may suggest a beneficial effect of policy changes since the ARRIVE trial publication and the negative effects from the coronavirus disease 2019 pandemic.</p><p><strong>Key points: </strong>· There was a trend toward decreasing perinatal mortality in 2019 compared with previous years.. · The downward trend in perinatal mortality may be attributed to an increase in 39-week deliveries.. · The downward trend in perinatal mortality did not persist into 2020, likely due to COVID-19..</p>\",\"PeriodicalId\":7584,\"journal\":{\"name\":\"American journal of perinatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of perinatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2511-8759\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2511-8759","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Perinatal Mortality Trend Associated with Maternal Obesity in United States between 2015 and 2020.
Objective: Obesity is associated with an increased risk of stillbirth and neonatal death. Since the publication of A Randomized Trial of Induction Versus Expectant Management (ARRIVE) in 2018, there was an increase in 39-week deliveries. The objective of this study was to evaluate the trends in perinatal mortality by body mass index (BMI) category from 2015 to 2020.
Study design: This was a retrospective cohort study of U.S. births between 2015 and 2020. The rates of stillbirths, infant deaths, and perinatal mortality were calculated for each BMI category. Logistic regression models were constructed based on specific outcome rates from 2015 to 2018 to predict the rates in 2019 and 2020. The predicted rates were compared with the actual rates to determine possible deviations due to policy and practice changes that occurred.
Results: Between 2015 and 2018, the stillbirth rate increased for ascending BMI categories. Whereas the neonatal death rate decreased for all except the underweight group, the perinatal death rate increased in all except for those with category III obesity. In 2019 the perinatal mortality rate decreased for every BMI category except underweight group. In 2020, the rate of infant deaths increased for all BMI categories compared with the predicted rates. The results were similar after excluding common comorbidities.
Conclusion: Perinatal mortality rates improved in 2019, reversing the increasing trend from 2015 to 2018. However, this trend did not persist for some BMI categories in 2020. These findings may suggest a beneficial effect of policy changes since the ARRIVE trial publication and the negative effects from the coronavirus disease 2019 pandemic.
Key points: · There was a trend toward decreasing perinatal mortality in 2019 compared with previous years.. · The downward trend in perinatal mortality may be attributed to an increase in 39-week deliveries.. · The downward trend in perinatal mortality did not persist into 2020, likely due to COVID-19..
期刊介绍：
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.
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