JAMA：早产儿成年后生育率较低
3月26日出版的《美国医学协会期刊》（JAMA）刊发的一项有关婴儿诞生情况的研究文章指出，与足月产的婴儿相比，早产儿死亡率高，其成年之后生育率较低。
该文章的背景资料显示，早产儿是指在受精后37周之内出生的婴儿。其中在26周时出生的存活婴儿中，有60%会出现残疾；在31周时出生的婴儿中，30%会有残疾状。除此之外，人们对早产儿的长期死亡风险及总体健康状况所知甚少。
来自杜克大学医学中心的专家开展的这项研究，旨在测定早产儿的长期存活、生育及对下一代发生早产率是否会产生影响。研究人员对1967年～1988年来自挪威的超过116万人的数据进行了分析，并持续追踪到2002年底；同时还对1967年～1976年出生者的教育程度及生育结果进行了评估，该分析一直持续到2004年底。受调查者中有60354位早产儿，占总人数的5.2%。
研究人员发现，早产儿的死亡风险较高，22周～27周的早产男孩在1岁~5.9岁的死亡率为1.33%，6岁~12.9岁为1.01%，比足月产男孩高5.3倍；22周～27周出生的女孩，在1岁~5.9岁的死亡率为1.71%，比足月产女孩死亡率要高出9.7倍。而28周~32周出生的早产儿比足月产者死亡率增加了两倍多。
研究人员注意到，早产者成年后生育率也低于足月产者，22周~27周出生的男性、女性，其绝对生育率分别为13.9%和25%，其中男性生育率下降了76%，而女性则下降了67%；28周~32周出生的男性、女性，其绝对生育率分别为38.6%和59.2%，其中男性生育率下降了30%，女性下降了19%。（来源：健康报 李天舒）
生物谷推荐原始出处：
（JAMA），299(12):1429-1436，Geeta K. Swamy，Rolv Skjærven
Association of Preterm Birth With Long-term Survival, Reproduction, and Next-Generation Preterm Birth
Geeta K. Swamy, MD; Truls Østbye, MD, PhD; Rolv Skjærven, PhD
JAMA. 2008;299(12):1429-1436.
Context Preterm birth is a major cause of infant morbidity and mortality. Less is known about long-term health among persons born preterm.
Objective To determine the long-term effects of preterm birth on survival, reproduction, and next-generation preterm birth.
Design, Setting, and Participants Population-based, observational, longitudinal study using registry data from 1 167 506 singleton births in the Medical Birth Registry of Norway in 1967-1988. The cohort was followed up through 2002 for survival. The cohort was truncated to births from 1967-1976 for assessment of educational achievement and reproductive outcomes through 2004.
Main Outcome Measures In relation to sex and gestational age at birth, absolute mortality, risk of fetal, infant, child, and adolescent mortality, and incidence and risk of reproduction and next-generation preterm birth. Singleton term (37-42 weeks) fetal deaths and live births, stratified by sex, served as the reference group for all analyses.
Results The percentage who were born preterm was higher among boys (5.6%) than among girls (4.7%). Preterm participants had an increased risk of mortality throughout childhood. For boys born at 22 to 27 weeks, mortality rates were 1.33% and 1.01% for early and late childhood death, with relative risks (RRs) of 5.3 (95% confidence interval [CI], 2.0-14.2) and 7.0 (95% CI, 2.3-22.0), respectively. The mortality rate for girls born at 22 to 27 weeks was 1.71% for early childhood death, with an RR of 9.7 (95% CI, 4.0-23.7); there were no late childhood deaths. For 28 to 32 weeks, the early and late childhood mortality rates among boys were 0.73% and 0.37%, with RRs of 2.5 (95% CI, 1.6-3.7) and 2.3 (95% CI, 1.3-4.1), respectively. Girls born at 28 to 32 weeks did not have a significantly increased risk of childhood mortality. Reproduction was diminished for index participants born preterm. For men and women born at 22 to 27 weeks, absolute reproduction was 13.9% and 25%, with RRs of 0.24 (95% CI, 0.17-0.32) and 0.33 (95% CI, 0.26-0.42), respectively. For 28 to 32 weeks, absolute reproduction was 38.6% and 59.2% for men and women, with RRs of 0.7 (95% CI, 0.66-0.74) and 0.81 (95% CI, 0.78-0.85), respectively. Preterm women but not men were at increased risk of having preterm offspring.
Conclusion In persons born in Norway in 1967-1988, preterm birth was associated with diminished long-term survival and reproduction.
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