Risk factors for death in infancy persist into older age groups in England and Wales
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《英国医生杂志》
Deaths of children aged between 3 and 8 years have been compared on a large scale for the first time in England and Wales with risk factors present at birth.
Statisticians at the Office for National Statistics did a linked analysis of birth and death records for children who were born between 1993 and 2001 and died before 2004 under the age of 8 (Health Statistics Quarterly 2004;(24):30).
A strong association between low birth weight and high mortality was found not only to exist during infancy but to persist in children aged 1 to 4 and, to some extent, even in children aged 5 to 7.
At a press conference in London last week, Peter Goldblatt, chief medical statistician, suggested that these findings underpin the importance of the "Barker hypothesis." David Barker, professor of epidemiology at Southampton University, pioneered the idea that adult disease may have its origins in fetal and infant life.
The report also gives information on social factors that seem to play a role in the survival of children aged less than 8. The mortality for children of fathers in manual occupations was significantly higher than for the children of fathers in non-manual occupations at each age. Also, between 1993 and 2001, children of unmarried couples had an overall 35% higher mortality rate than children who were born inside a marriage. The difference was most striking in infants, but remained significant throughout all ages.
Another key factor determining infant and childhood mortality was maternal age at delivery. Children born to mothers younger than 20 had the highest, whereas those born to mothers aged 30-34 had the lowest mortality (1082 v 581 deaths per 100 000 children of the same age between 1993 and 1995). This pattern was consistent throughout all ages included in the study. The latter age group happens to have the highest number of conceptions in England and Wales.
Which factors are most important in calculating a high risk of mortality for children is still unclear. The Office for National Statistics intends to do multivariate analyses with the same data to determine the main risk factors. Other projects considered include a large scale retrospective cohort study linking birth with death records of children under 18.
New statistics on conceptions in England and Wales show an overall increase of 3% between 2001 and 2002 (787 000 v 764 000 conceptions). Conceptions among under 18 year olds (in England only) increased by 2% from 2001 to 2002 to an estimated 42 000, and conceptions in girls aged under 16 simultaneously fell by 0.4% to 7875 (p 62).(BMJ Raghav Chawla)
Statisticians at the Office for National Statistics did a linked analysis of birth and death records for children who were born between 1993 and 2001 and died before 2004 under the age of 8 (Health Statistics Quarterly 2004;(24):30).
A strong association between low birth weight and high mortality was found not only to exist during infancy but to persist in children aged 1 to 4 and, to some extent, even in children aged 5 to 7.
At a press conference in London last week, Peter Goldblatt, chief medical statistician, suggested that these findings underpin the importance of the "Barker hypothesis." David Barker, professor of epidemiology at Southampton University, pioneered the idea that adult disease may have its origins in fetal and infant life.
The report also gives information on social factors that seem to play a role in the survival of children aged less than 8. The mortality for children of fathers in manual occupations was significantly higher than for the children of fathers in non-manual occupations at each age. Also, between 1993 and 2001, children of unmarried couples had an overall 35% higher mortality rate than children who were born inside a marriage. The difference was most striking in infants, but remained significant throughout all ages.
Another key factor determining infant and childhood mortality was maternal age at delivery. Children born to mothers younger than 20 had the highest, whereas those born to mothers aged 30-34 had the lowest mortality (1082 v 581 deaths per 100 000 children of the same age between 1993 and 1995). This pattern was consistent throughout all ages included in the study. The latter age group happens to have the highest number of conceptions in England and Wales.
Which factors are most important in calculating a high risk of mortality for children is still unclear. The Office for National Statistics intends to do multivariate analyses with the same data to determine the main risk factors. Other projects considered include a large scale retrospective cohort study linking birth with death records of children under 18.
New statistics on conceptions in England and Wales show an overall increase of 3% between 2001 and 2002 (787 000 v 764 000 conceptions). Conceptions among under 18 year olds (in England only) increased by 2% from 2001 to 2002 to an estimated 42 000, and conceptions in girls aged under 16 simultaneously fell by 0.4% to 7875 (p 62).(BMJ Raghav Chawla)