死产与严重的孕产妇发病率之间的关联
Samuel H Nyarko1, Lucy T Greenberg2, Ciaran S Phibbs3
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
American journal of obstetrics and gynecology
|September 2, 2023
概括
死产显著增加了在分娩期间住院和产后长达一年的严重孕产妇发病风险. 这一发现凸显出死胎是导致孕产妇健康并发症的关键因素.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 围产期流行病学 围产期流行病学
背景情况:
- 在全球范围内,严重孕产妇死亡率 (SMM) 正在上升.
- 有限的研究存在于死产和SMM之间的关联.
- 了解这种联系对于改善母亲的结果至关重要.
研究的目的:
- 调查与生产相比,死产的个体中SMM的患病率和风险.
- 分析SMM在分娩期间住院和产后期间.
- 使用可靠的统计方法量化死胎和SMM之间的关联.
主要方法:
- 追溯性队列研究,使用相关的出生/胎儿死亡证明和医院出院记录.
- 包括来自美国五个州的数据 (加利福尼亚州,密歇根州,密苏里州,宾夕法尼亚州,南卡罗来纳州) 跨越2008-2020年.
- 相对风险回归分析以确定SMM的调整相对风险,控制混变量.
主要成果:
- 死产 (0.40%) 与生产相比,与SMM的更高率有关.
- 在生育期间住院期间SMM的调整后相对风险为1.6 (95% CI,1.5-1.8) 对于死产.
- 增加的SMM风险持续到产后的一年 (SMM的aRR为1.3,非输血SMM的aRR为1.2).
结论:
- 死产是严重的孕产妇发病率的重要独立风险因素.
- 增加的SMM风险延伸到产后期.
- 临床关注和进一步的研究是有必要的,以减轻死产后的SMM风险.
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