Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Clin Infect Dis. 2021 Feb 16;72(4):668-674. doi: 10.1093/cid/ciaa113.
Race/ethnicity is currently not considered a risk factor for bronchiolitis, except for indigenous populations in Western countries. A better understanding of the potential impact of race/ethnicity can inform programs, policies, and practices related to bronchiolitis.
We performed a population-based, longitudinal, observational study using the State Inpatient Database from New York State in the United States. Infants born between 2009 and 2013 at term without comorbidities were followed for the first 2 years of life, up to 2015. We calculated the cumulative incidences among different race/ethnicity groups, and evaluated the risks by developing logistic regression models.
Of 877 465 healthy, term infants, 10 356 infants were hospitalized with bronchiolitis. The overall cumulative incidence was 11.8 per 1000 births. The cumulative incidences in non-Hispanic White, non-Hispanic Black, Hispanic, and Asian infants were 8.6, 15.4, 19.1, and 6.5 per 1000 births, respectively. In a multivariable analysis adjusting for socioeconomic status, the risks remained substantially high among non-Hispanic Black (odds ratio, 1.42; 95% confidence interval [CI], 1.34-1.51) and Hispanic infants (odds ratio, 1.77; 95% CI, 1.67-1.87), whereas being of Asian race was protective (odds ratio, .62; 95% CI, .56-.69).
The risks of bronchiolitis hospitalization in the first 2 years of life were substantially different by race/ethnicity, with Hispanic and Black infants having the highest rates of hospitalization. Further research is needed to develop and implement culturally appropriate public health interventions to reduce racial and ethnic health disparities in bronchiolitis.
除了西方国家的原住民外,目前种族/民族并不被认为是细支气管炎的危险因素。更好地了解种族/民族的潜在影响可以为细支气管炎的相关项目、政策和实践提供信息。
我们使用美国纽约州的州际住院数据库进行了一项基于人群的纵向观察性研究。在没有合并症的情况下,2009 年至 2013 年间足月出生的婴儿在生命的头 2 年被跟踪随访,直到 2015 年。我们计算了不同种族/民族群体的累积发病率,并通过建立逻辑回归模型评估了风险。
在 877465 名健康足月婴儿中,有 10356 名婴儿因细支气管炎住院。总体累积发病率为每 1000 例出生 11.8 例。非西班牙裔白种人、非西班牙裔黑种人、西班牙裔和亚洲婴儿的累积发病率分别为每 1000 例出生 8.6、15.4、19.1 和 6.5 例。在调整社会经济地位的多变量分析中,非西班牙裔黑种人(比值比,1.42;95%置信区间[CI],1.34-1.51)和西班牙裔婴儿(比值比,1.77;95% CI,1.67-1.87)的风险仍然显著较高,而亚洲种族则具有保护作用(比值比,0.62;95% CI,0.56-0.69)。
在生命的头 2 年,细支气管炎住院的风险因种族/民族而异,西班牙裔和黑种人婴儿的住院率最高。需要进一步研究制定和实施文化上适当的公共卫生干预措施,以减少细支气管炎中种族和民族健康差距。