低帝王切開率の国々における帝王切開へのアクセスを改善することと関連した,回避可能な妊産婦および新生児死亡率:生態学モデル分析

George Molina¹, Micaela M Esquivel², Tarsicio Uribe-Leitz²

¹Ariadne Labs at Brigham and Women's Hospital and the Harvard T H Chan School of Public Health, Boston, MA, USA; Massachusetts General Hospital, Department of Surgery, Boston, MA, USA.

Lancet (London, England)

|August 28, 2015

まとめ

低所得国における帝王切開率の上昇は妊産婦と新生児の死亡率を大幅に減らすことができますこの介入によって毎年 16万人の母と 800,000人の新生児の死亡を防ぐことができます

科学分野:

世界保健
産婦人科
公衆衛生

背景:

妊産婦と新生児の死亡率は世界的に深刻な健康問題です
以前の研究では,帝王切開による出産率 (CDR) と死亡率との間には,約19%の逆相関が示された.

研究の目的:

CDRが低い国における母と新生児の死亡率の減少の可能性を調査する.
CDRを7.2%から19.1%の範囲まで増やす効果をモデル化する.

主な方法:

世界銀行の開発指標を用いたCDR≤7.2%の45か国における母と新生児死亡率の分析
CDRが7.2%から19.1%の国の妊産婦死亡率 (MMR) と新生児死亡率 (NMR) の25パーセントと現在の割合を比較することによって死亡率の減少をモデル化する.

主要な成果:

低CDR国では推定176,078人の母親と1,117,257人の新生児が死亡しました.
CDRを基準値まで引き上げれば,妊産婦の死亡率は109,762163,513人,新生児の死亡率は279,584803,129人に減少する可能性があります.

結論:

低CDRの国で安全な帝王切開へのアクセスを拡大することで,かなりの数の妊産婦と新生児の死亡を防ぐことができます.
医療制度の能力,医療の質,患者の救出能力の改善を前提としています
安全な帝王切開へのアクセスを向上させることは極めて重要な世界的な外科医療の優先事項です

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