PDF(Pubmed)
Abstract：
BACKGROUND: Congenital hydrocephaly, an abnormal accumulation of fluid within the ventricular spaces at birth, can cause disability or death if untreated. Limited information is available about survival of infants born with hydrocephaly in Texas. Therefore, the purpose of the study was to calculate survival estimates among infants born with hydrocephaly without spina bifida in Texas.
METHODS: A cohort of live-born infants delivered during 1999-2017 with congenital hydrocephaly without spina bifida was identified from the Texas Birth Defects Registry. Deaths within 1 year of delivery were identified using vital and medical records. One-year infant survival estimates were generated for multiple descriptive characteristics using the Kaplan-Meier method. Crude hazard ratios (HRs) for one-year survival among infants with congenital hydrocephaly by maternal and infant characteristics and adjusted HRs for maternal race and ethnicity were estimated using Cox proportional hazard models.
RESULTS: Among 5709 infants born with congenital hydrocephaly without spina bifida, 4681 (82%) survived the first year. The following characteristics were associated with infant survival: maternal race and ethnicity, clinical classification (e.g., chromosomal or syndromic), preterm birth, birth weight, birth year, and maternal education. In the multivariable Cox proportional hazards model, differences in survival were observed by maternal race and ethnicity after adjustment for other maternal and infant characteristics. Infants of non-Hispanic Black (HR: 1.28, 95% CI: 1.04-1.58) and Hispanic (HR: 1.31, 95% CI: 1.12-1.54) women had increased risk for mortality, compared with infants of non-Hispanic White women.
CONCLUSIONS: This study showed infant survival among a Texas cohort differed by maternal race and ethnicity, clinical classification, gestational age, birth weight, birth year, and maternal education in infants with congenital hydrocephaly without spina bifida. Findings confirm that mortality continues to be common among infants with hydrocephaly without spina bifida. Additional research is needed to identify other risk factors of mortality risk.
METHODS: A cohort of live-born infants delivered during 1999-2017 with congenital hydrocephaly without spina bifida was identified from the Texas Birth Defects Registry. Deaths within 1 year of delivery were identified using vital and medical records. One-year infant survival estimates were generated for multiple descriptive characteristics using the Kaplan-Meier method. Crude hazard ratios (HRs) for one-year survival among infants with congenital hydrocephaly by maternal and infant characteristics and adjusted HRs for maternal race and ethnicity were estimated using Cox proportional hazard models.
RESULTS: Among 5709 infants born with congenital hydrocephaly without spina bifida, 4681 (82%) survived the first year. The following characteristics were associated with infant survival: maternal race and ethnicity, clinical classification (e.g., chromosomal or syndromic), preterm birth, birth weight, birth year, and maternal education. In the multivariable Cox proportional hazards model, differences in survival were observed by maternal race and ethnicity after adjustment for other maternal and infant characteristics. Infants of non-Hispanic Black (HR: 1.28, 95% CI: 1.04-1.58) and Hispanic (HR: 1.31, 95% CI: 1.12-1.54) women had increased risk for mortality, compared with infants of non-Hispanic White women.
CONCLUSIONS: This study showed infant survival among a Texas cohort differed by maternal race and ethnicity, clinical classification, gestational age, birth weight, birth year, and maternal education in infants with congenital hydrocephaly without spina bifida. Findings confirm that mortality continues to be common among infants with hydrocephaly without spina bifida. Additional research is needed to identify other risk factors of mortality risk.
摘要：
背景：先天性脑积水，出生时心室空间内液体的异常积聚，如果不治疗会导致残疾或死亡。关于德克萨斯州出生的脑积水婴儿的生存信息有限。因此,本研究的目的是计算德克萨斯州出生时无脊柱裂的脑积水婴儿的生存估计值.
方法：从得克萨斯州出生缺陷登记处确定了一组在1999-2017年期间分娩的无脊柱裂的先天性脑积水的活产婴儿。使用生命和医疗记录确定分娩后1年内的死亡。使用Kaplan-Meier方法为多个描述性特征生成一年婴儿存活估计值。使用Cox比例风险模型估算了根据母婴特征的先天性脑积水婴儿一年生存的粗风险比（HR），以及针对母体种族和种族的调整后的HR。
结果：在5709名先天性脑积水无脊柱裂的婴儿中，4681（82%）第一年存活。以下特征与婴儿生存相关：母亲种族和种族，临床分类(例如，染色体或综合征)，早产,出生体重,出生年份,和母亲教育。在多变量Cox比例风险模型中，在校正了其他母婴特征后,根据母体种族和种族观察到了生存率的差异.非西班牙裔黑人（HR：1.28，95％CI：1.04-1.58）和西班牙裔（HR：1.31，95％CI：1.12-1.54）妇女的婴儿死亡风险增加，与非西班牙裔白人女性的婴儿相比。
结论：这项研究表明，德克萨斯州队列中的婴儿存活率因母亲种族和种族而异，临床分类，胎龄,出生体重,出生年份,先天性脑积水无脊柱裂婴儿的母亲教育。研究结果证实，死亡率在无脊柱裂的脑积水婴儿中仍然很常见。需要进一步的研究来确定死亡风险的其他风险因素。
方法：从得克萨斯州出生缺陷登记处确定了一组在1999-2017年期间分娩的无脊柱裂的先天性脑积水的活产婴儿。使用生命和医疗记录确定分娩后1年内的死亡。使用Kaplan-Meier方法为多个描述性特征生成一年婴儿存活估计值。使用Cox比例风险模型估算了根据母婴特征的先天性脑积水婴儿一年生存的粗风险比（HR），以及针对母体种族和种族的调整后的HR。
结果：在5709名先天性脑积水无脊柱裂的婴儿中，4681（82%）第一年存活。以下特征与婴儿生存相关：母亲种族和种族，临床分类(例如，染色体或综合征)，早产,出生体重,出生年份,和母亲教育。在多变量Cox比例风险模型中，在校正了其他母婴特征后,根据母体种族和种族观察到了生存率的差异.非西班牙裔黑人（HR：1.28，95％CI：1.04-1.58）和西班牙裔（HR：1.31，95％CI：1.12-1.54）妇女的婴儿死亡风险增加，与非西班牙裔白人女性的婴儿相比。
结论：这项研究表明，德克萨斯州队列中的婴儿存活率因母亲种族和种族而异，临床分类，胎龄,出生体重,出生年份,先天性脑积水无脊柱裂婴儿的母亲教育。研究结果证实，死亡率在无脊柱裂的脑积水婴儿中仍然很常见。需要进一步的研究来确定死亡风险的其他风险因素。
