高社会经济地位如何影响孕产妇和新生儿妊娠结局?一项以美国妇女为基础的研究

IF 1.5 Q3 OBSTETRICS & GYNECOLOGY
Laura Nicholls-Dempsey , Ahmad Badeghiesh , Haitham Baghlaf , Michael H. Dahan
{"title":"高社会经济地位如何影响孕产妇和新生儿妊娠结局?一项以美国妇女为基础的研究","authors":"Laura Nicholls-Dempsey ,&nbsp;Ahmad Badeghiesh ,&nbsp;Haitham Baghlaf ,&nbsp;Michael H. Dahan","doi":"10.1016/j.eurox.2023.100248","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study was to evaluate the effect of high SES on multiple pregnancy outcomes, while controlling for confounding factors.</p></div><div><h3>Methods</h3><p>Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS), the largest American medical database including 20 % of annual hospital admissions, we studied the years 2004–2014 inclusively. We conducted a population-based retrospective cohort study consisting of women from different median household income quartiles throughout the United States. Women in the highest household income quartile were compared to those in all other lower income quartiles combined. Chi-square and Fischer exact tests were used to compare demographic and baseline characteristics. Univariate and multivariate regression analyses were carried to adjust for confounding factors, including ethnicity, pre-existing conditions, smoking status, obesity, illicit drug use and insurance type.</p></div><div><h3>Results</h3><p>Among 5,448,255 deliveries during the study period with income data, 1,218,989 deliveries were to women from the wealthiest median household income. These women were more likely to be older, Caucasian, and have private medical insurance (P &lt; 0.05, all). They were less likely to smoke, have chronic hypertension, pre-gestational diabetes, and use illicit drugs (P &lt; 0.05, all). They were less likely to develop complications including gestational hypertension (aOR 0.87 95 %CI 0.85–0.88), preeclampsia (aOR 0.88 95 %CI 0.86–0.89), eclampsia (aOR 0.81 95 %CI 0.66–0.99), gestational diabetes (aOR 0.91 95 %CI 0.89–0.92), preterm premature rupture of membranes (PPROM) (aOR 0.92 95 %CI 0.88–0.96), preterm birth (aOR 0.90 95 %CI 0.89–0.92), and placental abruption (aOR 0.89 95 %CI 0.85–0.93). They were less likely to have an intra-uterine fetal death (IUFD) (aOR 0.80 95 %CI 0.74–0.86), but more likely to deliver neonates with congenital anomalies (aOR 1.10 95 %CI 1.04–1.20).</p></div><div><h3>Conclusions</h3><p>Higher SES predisposes to better pregnancy outcomes, even when controlled for confounding factors such as ethnicity and underlying baseline health status. Efforts are required in order to eliminate health disparities in pregnancy.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"How does high socioeconomic status affect maternal and neonatal pregnancy outcomes? A population-based study among American women\",\"authors\":\"Laura Nicholls-Dempsey ,&nbsp;Ahmad Badeghiesh ,&nbsp;Haitham Baghlaf ,&nbsp;Michael H. Dahan\",\"doi\":\"10.1016/j.eurox.2023.100248\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>The purpose of this study was to evaluate the effect of high SES on multiple pregnancy outcomes, while controlling for confounding factors.</p></div><div><h3>Methods</h3><p>Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS), the largest American medical database including 20 % of annual hospital admissions, we studied the years 2004–2014 inclusively. We conducted a population-based retrospective cohort study consisting of women from different median household income quartiles throughout the United States. Women in the highest household income quartile were compared to those in all other lower income quartiles combined. Chi-square and Fischer exact tests were used to compare demographic and baseline characteristics. Univariate and multivariate regression analyses were carried to adjust for confounding factors, including ethnicity, pre-existing conditions, smoking status, obesity, illicit drug use and insurance type.</p></div><div><h3>Results</h3><p>Among 5,448,255 deliveries during the study period with income data, 1,218,989 deliveries were to women from the wealthiest median household income. These women were more likely to be older, Caucasian, and have private medical insurance (P &lt; 0.05, all). They were less likely to smoke, have chronic hypertension, pre-gestational diabetes, and use illicit drugs (P &lt; 0.05, all). They were less likely to develop complications including gestational hypertension (aOR 0.87 95 %CI 0.85–0.88), preeclampsia (aOR 0.88 95 %CI 0.86–0.89), eclampsia (aOR 0.81 95 %CI 0.66–0.99), gestational diabetes (aOR 0.91 95 %CI 0.89–0.92), preterm premature rupture of membranes (PPROM) (aOR 0.92 95 %CI 0.88–0.96), preterm birth (aOR 0.90 95 %CI 0.89–0.92), and placental abruption (aOR 0.89 95 %CI 0.85–0.93). They were less likely to have an intra-uterine fetal death (IUFD) (aOR 0.80 95 %CI 0.74–0.86), but more likely to deliver neonates with congenital anomalies (aOR 1.10 95 %CI 1.04–1.20).</p></div><div><h3>Conclusions</h3><p>Higher SES predisposes to better pregnancy outcomes, even when controlled for confounding factors such as ethnicity and underlying baseline health status. Efforts are required in order to eliminate health disparities in pregnancy.</p></div>\",\"PeriodicalId\":37085,\"journal\":{\"name\":\"European Journal of Obstetrics and Gynecology and Reproductive Biology: X\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-10-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Obstetrics and Gynecology and Reproductive Biology: X\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S259016132300073X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S259016132300073X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 1

摘要

目的本研究的目的是评估高SES对多胎妊娠结局的影响,同时控制混杂因素。方法利用美国最大的医疗数据库——全国住院患者样本医疗成本与利用项目(HCUP-NIS),包括20%的年住院人数,我们对2004年至2014年进行了全面研究。我们进行了一项基于人群的回顾性队列研究,该研究由来自美国不同家庭收入中位数四分位数的女性组成。将家庭收入最高四分位数的妇女与所有其他低收入四分位数妇女的总和进行比较。卡方检验和菲舍尔精确检验用于比较人口统计学和基线特征。进行单变量和多变量回归分析,以调整混杂因素,包括种族、先前存在的疾病、吸烟状况、肥胖、非法药物使用和保险类型。结果在有收入数据的研究期间,5448255次分娩中,1218989次是给家庭收入中位数最富有的女性分娩的。这些女性更有可能是老年人、高加索人,并有私人医疗保险(均P<;0.05)。他们不太可能吸烟、患有慢性高血压、妊娠前糖尿病和使用非法药物(均P<;0.05)。他们不太可能出现并发症,包括妊娠期高血压(aOR 0.87 95%CI 0.85–0.88)、先兆子痫(aOR 0.8 8 95%CI 0.86–0.89)、子痫(aOR0.81 95%CI 0.66–0.99)、妊娠期糖尿病(aOR 0.91 95%CI 0.89–0.92)、早产胎膜早破(PPROM),和胎盘早剥(aOR 0.89 95%CI 0.85–0.93)。她们不太可能发生宫内胎儿死亡(IUFD)(aOR 0.80 95%CI 0.74–0.86),但更有可能分娩先天性异常的新生儿(aOR 1.10 95%CI 1.04–1.20)。结论SES越高,妊娠结局越好,即使在对种族和潜在的基线健康状况等混杂因素进行控制的情况下。需要努力消除怀孕期间的健康差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How does high socioeconomic status affect maternal and neonatal pregnancy outcomes? A population-based study among American women

Objectives

The purpose of this study was to evaluate the effect of high SES on multiple pregnancy outcomes, while controlling for confounding factors.

Methods

Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS), the largest American medical database including 20 % of annual hospital admissions, we studied the years 2004–2014 inclusively. We conducted a population-based retrospective cohort study consisting of women from different median household income quartiles throughout the United States. Women in the highest household income quartile were compared to those in all other lower income quartiles combined. Chi-square and Fischer exact tests were used to compare demographic and baseline characteristics. Univariate and multivariate regression analyses were carried to adjust for confounding factors, including ethnicity, pre-existing conditions, smoking status, obesity, illicit drug use and insurance type.

Results

Among 5,448,255 deliveries during the study period with income data, 1,218,989 deliveries were to women from the wealthiest median household income. These women were more likely to be older, Caucasian, and have private medical insurance (P < 0.05, all). They were less likely to smoke, have chronic hypertension, pre-gestational diabetes, and use illicit drugs (P < 0.05, all). They were less likely to develop complications including gestational hypertension (aOR 0.87 95 %CI 0.85–0.88), preeclampsia (aOR 0.88 95 %CI 0.86–0.89), eclampsia (aOR 0.81 95 %CI 0.66–0.99), gestational diabetes (aOR 0.91 95 %CI 0.89–0.92), preterm premature rupture of membranes (PPROM) (aOR 0.92 95 %CI 0.88–0.96), preterm birth (aOR 0.90 95 %CI 0.89–0.92), and placental abruption (aOR 0.89 95 %CI 0.85–0.93). They were less likely to have an intra-uterine fetal death (IUFD) (aOR 0.80 95 %CI 0.74–0.86), but more likely to deliver neonates with congenital anomalies (aOR 1.10 95 %CI 1.04–1.20).

Conclusions

Higher SES predisposes to better pregnancy outcomes, even when controlled for confounding factors such as ethnicity and underlying baseline health status. Efforts are required in order to eliminate health disparities in pregnancy.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.20
自引率
0.00%
发文量
31
审稿时长
58 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信