死産:高所得国における前進の道
Vicki Flenady1, Philippa Middleton, Gordon C Smith
1Mater Medical Research Institute, South Brisbane, QLD, Australia. Vicki.Flenady@mmri.mater.org.au
Lancet (London, England)
|April 19, 2011
まとめ
高所得国の死産率は停滞している. 社会経済的な格差に対処し,肥満や喫煙などの変更可能な危険因子,妊娠前期および産前ケアを改善することは,予防に不可欠です.
科学分野:
- 産経周りの健康について
- 公衆衛生は公衆衛生である.
- 産科は産婦人科です.
背景:
- 高所得国における死産率は,歴史的に顕著な減少を経て,平準化している.
- 現存する死産率の変動は,さらなる減少の可能性を示唆している.
- 社会経済的な格差,胎盤の病変,感染症,および修飾可能な母性の要因が死産に寄与する.
研究 の 目的:
- 現在の傾向を見直し,高所得国における死産率に影響を与える重要な要因を特定する.
- 死産を減らすための介入と研究の分野を強調する.
- 改善されたデータ収集と標準化された定義の必要性を強調する.
主な方法:
- 既存の文献と死産傾向とリスク要因に関するデータのレビュー.
- 社会経済的な不利益に関連した格差の分析.
- 体重過剰,肥満,喫煙,母親の高齢化などの変更可能なリスク要因の特定.
主要な成果:
- 社会経済的な格差に対処し,生活条件を改善することで,死産のさらなる減少は可能である.
- 胎盤の病理,感染症,体重増加,肥満,喫煙,および母親の高齢化が重要なリスク因子です.
- 原因不明の死産は,予防の取り組みにとって,依然として大きな課題となっている.
結論:
- 文化的に適切な先入観と,アクセシブルな品質の産前ケアが不可欠です.
- 国家間死亡率の監査と標準化された死産調査 (解剖と胎盤組織病理学を含む) は,死亡率を減らすことができます.
- 胎盤機能障害と妊産婦の肥満に対するスクリーニングと介入に関する研究は,最優先事項です.
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