社会经济劣势与贫血的风险和严重程度有关[j]

Jaclyn M. Phillips, Francis M. Hacker, Lara S Lemon, H. Simhan, Jayanthi Simhan, Uma Simhan
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引用次数: 0

摘要

导言:入院分娩时贫血是围产期输血的重要因素。包括输血在内的孕产妇发病风险与社区贫困有关。我们试图探索社区水平剥夺与入院分娩时贫血的频率和严重程度之间的关系。方法:我们进行了一项经irb批准的回顾性队列分析,分析了2015年至2020年单一医疗保健网络的分娩入院情况。区域剥夺指数(Area deprivation index, ADI)是一个涵盖收入、教育、家庭特征和住房的社区综合指数,用来表征社区的社会经济劣势。该指数的取值范围为1 ~ 100,数值越大,表示劣势越大。贫血定义为血红蛋白低于11.0 mg/dL和严重贫血低于9.0 mg/dL。多变量二项回归模型评估了ADI与贫血之间的关系。结果:共纳入八万五千五百五十三例分娩入院。ADI与贫血呈单调线性正相关。居住在最弱势社区(ADI>95)的个体在入院分娩时贫血的几率(95% CI 2.1-2.3)为2.2倍。例如,生活在弱势社区(ADI为5)的人预测贫血的概率为11%,而生活在弱势社区(ADI为95)的人预测贫血的概率为23%。生活在最贫困社区的个体有更高的严重贫血率(1%比3%,P< 0.001)。结论:生活在弱势社区的个体更容易出现贫血,贫血程度也更严重。社区一级的干预措施可用于针对贫血高风险人群,并可能影响孕产妇结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Socioeconomic Disadvantage Is Associated With Risk and Severity of Anemia [ID: 1377641]
INTRODUCTION: Anemia on admission for delivery is a significant contributor to peripartum transfusion. Risk of maternal morbidity including transfusion has been linked to neighborhood deprivation. We sought to explore the relationship between a composite measure of neighborhood-level deprivation and frequency and severity of anemia on admission for delivery. METHODS: We performed an IRB-approved retrospective cohort analysis of delivery admissions in a single health care network from 2015 to 2020. Area deprivation index (ADI) was used to represent neighborhood socioeconomic disadvantage and is a composite index of neighborhood that spans income, education, household characteristics, and housing. The index ranges from 1 to 100 with higher values indicating higher disadvantage. Anemia was defined as hemoglobin less than 11.0 mg/dL and severe anemia less than 9.0 mg/dL. Multivariable binomial regression models assessed the relationship between ADI and anemia. RESULTS: Eighty-five thousand five hundred fifty-three delivery admissions were included. A monotonic linear positive relationship was observed between ADI and anemia. Individuals who reside in the most disadvantaged neighborhoods (ADI>95) had 2.2 times the odds (95% CI 2.1–2.3) of anemia on admission for delivery. For example, individuals who live in a less disadvantaged neighborhood (ADI of 5) had a 11% predicted probability of anemia compared to 23% in individuals who lived in a more disadvantaged neighborhood (ADI of 95). Individuals who lived in the most disadvantaged neighborhoods had a higher rate of severe anemia (1% versus 3%, P<.001). CONCLUSION: Anemia is more likely and more severe in individuals living in disadvantaged neighborhoods. Neighborhood-level interventions could be used to target populations at high risk for anemia and potentially affect maternal outcomes.
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