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在低剖腹产率的国家改善剖腹产的可避免产妇和新生儿死亡率:生态建模分析
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
概括
在低资源国家增加剖腹产率可以显著减少产妇和新生儿死亡率. 这种干预有可能每年避免超过16万名母亲和80万名新生儿死亡.
科学领域:
- 全球健康
- 产科和妇科
- 公共卫生
背景情况:
- 孕产妇和新生儿死亡率仍然是全球卫生面临的重大挑战.
- 之前的研究表明剖腹产率与死亡率之间的反向相关性高达约19.0%.
研究的目的:
- 研究在CDR较低的国家减少孕产妇和新生儿死亡的可能性.
- 将CDR增加到7.2%19.1%的范围的影响建模.
主要方法:
- 用世界银行发展指标分析45个国家母婴死亡率 (CDR) ≤7.2%.
- 通过将目前的死亡率与7.2%至19.1%之间的母婴死亡率 (MMR) 和新生儿死亡率 (NMR) 的百分比进行比较,以建模死亡率的降低.
主要成果:
- 估计有176,078名母亲和1,117,257名新生儿在研究的低CDR国家死亡.
- 将CDR提高到基准范围每年可能减少109,762163,513的孕产妇死亡率和279,584803,129的新生儿死亡率.
结论:
- 在CDR较低的国家扩大安全剖腹产的机会可以避免大量的产妇和新生儿死亡.
- 这需要同时提高医疗系统的能力,医疗质量和患者救援能力.
- 增加安全剖腹产的机会是全球最重要的外科护理优先事项.
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