高收入国家死产的主要风险因素:系统审查和元分析
Vicki Flenady1, Laura Koopmans, Philippa Middleton
1Mater Medical Research Institute, South Brisbane, QLD, Australia. vicki.flenady@mmri.mater.org.au
Lancet (London, England)
|April 19, 2011
概括
在高收入国家,通过准可改变的风险因素,如母亲超重,肥胖,晚年母亲和吸烟,可以改善死产预防. 解决这些因素是降低死产率的关键.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 高收入国家的死产率已经停滞了20年.
- 针对风险因素的预防策略对于降低率至关重要.
- 本次审查确定了这些国家预防死产的优先领域.
研究的目的:
- 进行系统审查和元分析.
- 为了确定死产的可修改的风险因素.
- 为高收入国家的预防策略提供信息.
主要方法:
- 对基于人群的研究进行系统审查和元分析.
- 识别和选择经常报告的可修改的风险因素.
- 为所选因素计算人口可归因风险 (PAR) 值.
主要成果:
- 孕产妇超重/肥胖是主要可修改的风险因素 (PAR 8-18%),每年导致约8000例死产.
- 较晚的孕产妇年龄 (>35) 和吸烟分别导致每年超过4200例和超过2800例死产.
- 胎盘病理 (例如,对于妊娠年龄来说很小,脱落) 和先前存在的疾病 (糖尿病,高血压) 是显著的贡献者.
结论:
- 优先考虑可修改的风险因素的干预措施对于预防死产至关重要.
- 对超重,肥胖,产妇年龄和吸烟的认识和有效干预至关重要.
- 解决胎盘病理和先前存在的疾病也仍然很重要.
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