预防早产:对39个人类发展指数非常高的国家进行干预,分析趋势和潜在的减少
Hannah H Chang1, Jim Larson, Hannah Blencowe
1Boston Consulting Group, Boston, MA, USA.
Lancet (London, England)
|November 20, 2012
概括
实施基于证据的干预措施可以将早产减少5%,每年避免58,000例婴儿死亡. 关键策略包括戒烟和减少非医疗指示的剖腹产.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿健康 新生儿健康
- 公共卫生 公共卫生
背景情况:
- 全球每年有1500万名早产婴儿受到影响,幸存者中患早产婴儿的比例越来越高,残疾严重.
- 了解早产的驱动因素和有效的预防干预措施仍然有限.
- 本研究重点关注具有非常高的人类发展指数 (VHHDI) 的国家,以评估潜在的早产率降低.
研究的目的:
- 检查VHHDI国家早产率的趋势.
- 通过广泛实施基于证据的干预措施,估计可能减少早产的可能性.
- 为了为"出生太快"倡议制定降息目标.
主要方法:
- 对39个VHHDI国家的早产患病率数据 (2000-2010年) 和趋势预测的分析.
- 美国早产率上升的驱动因素的调查 (1989-2004).
- 在高覆盖率下,对五项关键干预措施 (戒烟,减少多重胚胎移植,宫 cerclage,孕激素补充,减少非医疗指示的分娩诱导/剖腹产) 的建模.
主要成果:
- 即使在表现最佳的国家,VHHDI国家到2015年早产率的相对减少也将低于5%.
- 在美国,一半的早产增加是无法解释的,劳动诱导,剖腹产和辅助生殖技术的重大贡献.
- 建模预测,早产率将相对减少5% (从9.59%降至9.07%),五项干预措施的高覆盖率,避免了约58,000例分娩,每年节省约30亿美元.
结论:
- 建议采取保守的目标,到2015年将早产率相对降低5%.
- 迫切需要对早产机制和创新的干预措施进行研究.
- 关注低收入环境至关重要,因为原因和解决方案 (例如,分娩间隔,感染治疗) 可能有所不同.
相关概念视频
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