死产:我们能做出什么改变,代价是什么?
Zulfiqar A Bhutta1, Mohammad Yawar Yakoob, Joy E Lawn
1Division of Women and Child Health, Aga Khan University, Karachi, Pakistan. zulfiqar.bhutta@aku.edu
Lancet (London, England)
|April 19, 2011
概括
有效的死产预防策略,包括叶酸,疟疾预防和梅毒管理,可以显著减少死产的全球负担,特别是在资源较低的环境中. 实施这些干预措施可以避免高达45%的死产.
科学领域:
- 全球健康 全球健康
- 产科和妇科 产科和妇科
- 预防医学 预防医学
背景情况:
- 死产是一个重大的全球卫生挑战,每年发生265万例,主要发生在低收入和中等收入国家 (LMIC).
- 产内死胎占全球负担的45%以上,但有效的干预措施,特别是对于资源有限的环境,被认为是缺乏的.
- 解决死胎问题对于改善母亲,胎儿和新生儿健康状况至关重要.
研究的目的:
- 系统地审查随机试验和观察性研究,以减少死产的干预措施,重点关注LMICs.
- 确定适合在全球卫生系统中实施的基于证据的干预措施.
- 估计实施这些干预措施的潜在影响和成本效益.
主要方法:
- 随机对照试验和观察性研究的系统审查.
- 包括旨在减少死产的干预措施,特别是在LMICs.
- 使用"拯救生命工具" (LiST) 进行建模,以估计避免的死产.
主要成果:
- 具有足够的实施证据的关键干预措施包括经受孕期间补充/强化叶酸,预防疟疾和在流行地区检测/管理梅毒.
- 基本和全面的急诊产科护理对于减少产前死胎至关重要.
- 建模表明,在68个优先国家实施干预计划可以避免高达45%的死产.
结论:
- 基于证据的干预措施可用于显著减少全球死产负担.
- 实施干预方案,包括紧急产科护理,具有成本效益,可以避免大量的死产.
- 专注于这些LMIC干预措施对于改善孕产妇和新生儿存活率至关重要.
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