死亡出生率,风险因素和到2030年的加速
Joy E Lawn1, Hannah Blencowe1, Peter Waiswa2
1Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical Medicine, London, UK; Saving Newborn Lives, Save the Children, Washington, DC, USA.
Lancet (London, England)
|January 23, 2016
概括
每年都有数以百万计的死产, 改善出生护理和数据登记对于防止这些可预防的悲剧至关重要.
科学领域:
- 全球健康
- 妇产科
- 周围生理学
背景情况:
- 2015年估计有260万例第三季度死产,减少的进展速度比母婴死亡率慢.
- 每个新生儿行动计划的目标是到2030年,每1000个新生儿死亡的数量为12个或更少.
研究的目的:
- 分析死胎的全球负担,确定主要原因和风险因素,并强调需要改进数据收集和干预措施.
- 强调改善产后护理在预防死产和相关产妇和新生儿死亡方面的关键作用.
主要方法:
- 对全球死产估计和趋势的分析,包括对母婴死亡率的比较.
- 对死胎因果关系的数据的审查,重点是可修改的因素和胎盘功能的作用.
- 对新生儿和死胎的出生和死亡登记完整性的评估.
主要成果:
- 大多数死产 (98%) 发生在低收入和中等收入国家,
- 虽然先天性异常是很小的原因,但可以改变的因素如孕产妇感染,非传染性疾病,营养和长期怀孕有很大影响.
- 数据缺口很大,新生儿死亡人数不到5%,死亡出生人数更少,阻碍了针对性的干预.
结论:
- 许多国家需要加快进展才能实现"每一个新生儿行动计划"关于减少死胎的目标.
- 改善卫生设施中所有出生和死亡的数据收集和记录对于有效的死产预防策略至关重要.
- 专注于可修改的风险因素的有针对性的干预措施和增强的产后护理可以显著降低全球死产负担.
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