摘要
目的分析1990年至2021年我国可归因于早产与低出生体重(preterm birth and low birth weight,PBLBW)的疾病负担变化及趋势,为制定预防和干预策略提供科学依据。方法利用全球疾病负担(Global Burden of Disease,GBD)2021数据库,计算与PBLBW相关的死亡人数、伤残调整生命年(disability-adjusted life years,DALYs)及其年龄标化率(age-standardized rates,ASR)等指标,通过Joinpoint回归模型等分析疾病负担变化趋势、特定疾病影响、不同性别和年龄段差异,对比我国与全球及不同社会人口指数(socio-demographic index,SDI)区域的疾病负担,并运用自回归差分移动平均模型预测未来趋势。结果2021年,我国可归因于PBLBW的年龄标化死亡率(age-standardized mortality rate,ASMR)和年龄标化DALYs率(age-standardized DALYs rate,ASDR)分别为3.89/10万人与413.24年/10万人,相比较于1990年21.80/10万人与2027.96年/10万人均显著下降,平均年度百分比变化(average annual percentage change,AAPC)分别为-5.39与-5.03,但2021年男性相关疾病负担(ASMR:4.35/10万人;ASDR:459.48年/10万人)指标高于女性(ASMR:3.36/10万人;ASDR:359.55年/10万人)。2021年,早产是我国PBLBW相关死亡及DALYs的主要疾病,ASMR为2.65/10万人,ASDR为301.50年/10万人。2021年我国可归因于PBLBW的ASMR及ASDR低于低SDI区域、中低SDI区域、中SDI区域及全球水平,且在1990年至2021年间下降幅度远高于全球及5个SDI区域。预测2021年至2030年我国相关指标将持续下降,至2030年可归因于PBLBW的ASMR为1.63/10万人,ASDR为212.62年/10万人。结论我国在降低PBLBW疾病负担方面成效显著,但存在性别差异以及数据方法的局限性,仍需进一步强化围产保健体系建设。
Objective:To analyze the temporal trends and projections in disease burden attributable to preterm birth and low birth weight(PBLBW)in China from 1990 to 2021,providing evidence for prevention strategies.Methods:Using Global Burden of Disease(GBD)2021 data,deaths,disability-adjusted life years(DALYs),and age-standardized rates(ASR)related to PBLBW were calculated.Joinpoint regression analyzed temporal trends,disease-specific impacts,sex/age disparities,and comparisons with socio-demographic index(SDI)regions.An autoregressive integrated moving average(ARIMA)model projected future trends.Results:In 2021,age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR)for PBLBW were 3.89/100000 and 413.24 years/100000,respectively,which demonstrated a significant decline from 1990 levels(21.80/100000 and 2027.96 years/100000),with average annual percentage changes(AAPC)of-5.39 and-5.03.Male burden exceeded female in 2021(ASMR:4.35/100000 vs.3.36/100000;ASDR:459.48 years/100000 vs.359.55 years/100000).Preterm birth dominated PBLBW-related mortality and DALYs in 2021(ASMR:2.65/100000;ASDR:301.50 years/100000).China's 2021 ASMR and ASDR were lower than low-,low-middle-,and middle-SDI regions and global levels,with greater declines during 1990-2021 than global levels and all SDI regions.Projections indicate continued decline to 2030(ASMR:1.63/100000;ASDR:212.62 years/100000).Conclusion:China achieved substantial reductions in PBLBW-related disease burden,although persistent gender disparities and methodological limitations in data collection necessitate further strengthening of the perinatal healthcare system.
作者
冷雪
肖文艳
Leng Xue;Xiao Wenyan(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Second Department of Critical Care Medicine,the Second Affliated Hospital of Anhui Medical University,Hefei 23060l,China)
出处
《中华围产医学杂志》
北大核心
2025年第8期646-655,共10页
Chinese Journal of Perinatal Medicine
基金
安徽省卫生健康科研项目(AHWJ2022b085)
安徽省转化医学研究院科研基金(2022zhyx-C46)。
关键词
早产
低出生体重
发病率
死亡率
疾病负担
Preterm birth
Low birth weight
Incidence rate
Mortality
Disease burden
