2004年至2022年美国胎儿巨大儿患病率趋势

IF 1.2 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2025-09-16 DOI:10.1055/a-2696-3320

Peipei Hu, Guodong Ding, Chutian Shi, Angela Vinturache, Yongjun Zhang

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引用次数: 0

摘要

在全球范围内，巨大儿的患病率差异很大，巨大儿患病率的趋势存在争议。我们的目的是分析2004年至2022年胎儿巨大儿患病率的时间变化。这项研究包括来自美国国家生命统计系统出生档案的72,879,544例单胎分娩。我们使用Joinpoint回归评估胎儿巨大儿（出生体重：4,000 g）的年度趋势，进一步分为1级（4,000-4,499 g）， 2级（4,500-4,999 g）和3级（5,000 g）。胎儿巨大儿的总体患病率从2004年的8.85% （95% ci: 8.83, 8.88）总体下降到2022年的7.42% (95% ci: 7.40, 7.45)，平均每年相对下降0.89% （95% ci: -1.17%, -0.61%）。时间趋势呈非线性：2004-2007年急剧下降（APC: -3.63; 95% ci: -4.92, -2.32）， 2007-2015年略有上升（APC: 0.79; 95% ci: 0.41, 1.16）， 2015-2022年稳步下降（APC: -1.59; 95% ci: -1.98, -1.20）。亚组分析显示出持续的下降，年龄在50 - 30岁之间的女性、受过大学教育的女性、初产妇和亚洲/太平洋岛民母亲的下降更为明显。当按严重程度分层时，1级巨大儿的患病率从7.53%下降到6.42% (AAPC: -0.80; 95% ci: -1.06, -0.53)， 2级从1.13%下降到0.84% (AAPC:-1.50; 95% ci: -1.94, -1.06)， 3级从0.20%下降到0.16% （AAPC: -0.85; 95% ci: -1.42, -0.27）。胎儿巨大儿的患病率随着时间的变化而变化，在过去20年中总体呈下降趋势，有两个快速下降时期（2004-2007年和2015-2022年）和一个温和上升时期（2007-2015年）。1级和2级巨大儿变化明显，3级巨大儿也有下降趋势，但没有明显的节段斜率。·美国胎儿巨大儿总体患病率从2004年的8.85%下降到2022年的7.42%，呈两个下降期和一个适度上升期的非线性趋势。·这一趋势在40 - 30岁的女性、受过大学教育的女性、初产妇和亚洲/太平洋岛民母亲中更为明显。·严重程度分层分析显示，1级和2级明显下降，而3级表现出适度下降，没有明显的连接点段。

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Trends in the Prevalence of Fetal Macrosomia in the United States, 2004 to 2022.

Globally, the prevalence of macrosomia varies widely, and the trends in macrosomia prevalence are controversial. We aim to analyze temporal changes in fetal macrosomia prevalence from 2004 to 2022.This study included 72,879,544 singleton deliveries from the U.S. National Vital Statistics System Natality Files. We used Joinpoint regression to assess annual trends in fetal macrosomia (birth weight: 4,000 g), further classified into Grade 1 (4,000-4,499 g), Grade 2 (4,500-4,999 g), and Grade 3 (5,000 g).The overall prevalence of fetal macrosomia declined overall from 8.85% (95% CIs: 8.83, 8.88) in 2004 to 7.42% (95% CIs: 7.40, 7.45) in 2022, representing an average annual relative decrease of 0.89% (95% CIs: -1.17%, -0.61%). The temporal trend was nonlinear: a sharp decrease from 2004-2007 (APC: -3.63; 95% CIs: -4.92, -2.32), a modest increase during 2007-2015 (APC: 0.79; 95% CIs: 0.41, 1.16), and a steady decline from 2015-2022 (APC: -1.59; 95% CIs: -1.98, -1.20). Subgroup analyses revealed consistent declines, with more pronounced reductions among women aged > 30 years, those with a college education, primiparous women, and Asian/Pacific Islander mothers. When stratified by severity, the prevalence of Grade 1 macrosomia decreased from 7.53% to 6.42% (AAPC: -0.80; 95% CIs: -1.06, -0.53), Grade 2 decreased from 1.13% to 0.84% (AAPC:-1.50; 95% CIs: -1.94, -1.06), and Grade 3 from 0.20% to 0.16% (AAPC: -0.85; 95% CIs: -1.42, -0.27).The prevalence of fetal macrosomia has varied over time, showing an overall downward trend over the past 20 years, with two periods of rapid decline (2004-2007 and 2015-2022) and one period of moderate increase (2007-2015). The changes observed were significant for Grade 1 and Grade 2 macrosomia, while Grade 3 macrosomia also showed a downward trend, but without distinct segment slopes. · The overall prevalence of fetal macrosomia in the United States declined from 8.85% in 2004 to 7.42% in 2022, with a non-linear trend marked by two periods of decline and one of moderate increase.. · The trend was more pronounced among women aged >30 years, with college education, primiparous women, and Asian/Pacific Islander mothers.. · Severity-stratified analyses revealed significant declines in Grade 1 and Grade 2, while Grade 3 demonstrated a modest decrease without distinct Joinpoint segments..

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

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.