美国西奈山伊坎医学院联合瑞典隆德大学的研究人员在最新研究中，探讨了早产儿成人期无重大合并症的生存率。相关论文发表在2019年10月22日出版的《美国医学会杂志》上。
据悉，早产与成年期的心脏代谢、呼吸和神经精神疾病有关。然而，关于其无重大并发症的生存率尚不明确。
研究组对1973年1月1日至1997年12月31日在瑞典出生的2566699人进行了一项国家队列研究，这些人都有出生孕周的数据，并在2015年12月31日之前接受了一系列随访。对足月（39-41周）、超早产（22-27周）、极早产（28-33周）、晚期早产（34-36周）或早期足月儿（37-38周）成年期的无重大并发症的生存率进行分层统计与分析。
该研究人群中，女性占48.6%，早产儿占5.8%，随访结束时中位年龄为29.8岁。54.6%的早产儿在随访结束时还活着，没有合并症。进一步分层，超早产的生存率为22.3%，极早产为48.5%，晚期早产为58.0%，早期足月为61.2%，足月为63.0%。早产儿的生存率显著低于足月儿。进行校正后，全部早产儿的生存率为73.1%，超早产为32.5%，极早产为66.4%，晚期早产为77.1%，早期足月为80.4%，足月儿为81.8%。
总之，1973-1997年在瑞典出生的早产儿中，大多数存活至成年早期至中期，且无重大合并症。不幸的是，那些超早产儿存活率非常低。
Objective To determine the prevalence of survival without major comorbidities in adulthood among persons born preterm vs full-term.
Design, Setting, and Participants National cohort study of all 2?566?699 persons born in Sweden from January 1, 1973, through December 31, 1997, who had gestational age data and who were followed up for survival and comorbidities through December 31, 2015 (ages 18-43 years).Exposures Gestational age at birth.
Main Outcomes and Measures Survival without major comorbidities among persons born extremely preterm (22-27 weeks), very preterm (28-33 weeks), late preterm (34-36 weeks), or early term (37-38 weeks), compared with full-term (39-41 weeks). Comorbidities were defined using the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) Comorbidity Index, which includes conditions that commonly manifest in adolescence or young adulthood, including neuropsychiatric disorders; and the Charlson Comorbidity Index (CCI), which includes major chronic disorders predictive of mortality in adulthood. Poisson regression was used to determine prevalence ratios and differences, adjusted for potential confounders.Results In this study population, 48.6% were female, 5.8% were born preterm, and the median age at end of follow-up was 29.8 years (interquartile range, 12.6 years). Of all persons born preterm, 54.6% were alive with no AYA HOPE comorbidities at the end of follow-up. Further stratified, this prevalence was 22.3% for those born extremely preterm, 48.5% for very preterm, 58.0% for late preterm, 61.2% for early term, and 63.0% for full-term. These prevalences were significantly lower for earlier gestational ages vs full-term (eg, adjusted prevalence ratios: extremely preterm, 0.35 [95% CI, 0.33 to 0.36; P < .001]; all preterm, 0.86 [95% CI, 0.85 to 0.86; P < .001]; adjusted prevalence differences: extremely preterm, −0.41 [95% CI, −0.42 to −0.40; P < .001]; all preterm, −0.09 [95% CI, −0.09 to −0.09; P < .001]). Using the CCI, the corresponding prevalences were 73.1% (all preterm), 32.5% (extremely preterm), 66.4% (very preterm), 77.1% (late preterm), 80.4% (early term), and 81.8% (full-term) (adjusted prevalence ratios: extremely preterm, 0.39 [95% CI, 0.38 to 0.41; P < .001]; all preterm, 0.89 [95% CI, 0.89 to 0.89; P < .001]; adjusted prevalence differences: extremely preterm, −0.50 [95% CI, −0.51 to −0.49; P < .001]; all preterm, −0.09 [95% CI, −0.09 to −0.09; P < .001]).
Conclusions and Relevance Among persons born preterm in Sweden between 1973 and 1997, the majority survived to early to mid-adulthood without major comorbidities. However, outcomes were worse for those born extremely preterm. JAMA-Journal of The American Medical Association：《美国医学会杂志》，创刊于1883年。隶属于美国医学协会，最新IF：51.273
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