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在工作时间外分娩与严重孕产妇发病率风险之间的关联:全国性基于人口的队列研究
Il Yun1,2, Eun-Cheol Park2,3, Jin Young Nam4
1Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea.
Journal of clinical medicine
|November 14, 2023
概括
在非工作时间分娩,特别是在晚上,增加了严重孕产妇发病率 (SMM) 的风险. 这种风险在较小的城市和拥有100至499张床位的医院中明显更高.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在正常工作时间以外的分娩,定义为发生在标准工作时间之外的分娩,在产妇护理中很常见.
- 严重的孕产妇发病率 (SMM) 是一个重大的公共卫生问题,表明对母亲的健康有严重的短期或长期后果.
研究的目的:
- 调查非工作时间分娩时间与韩国严重孕产妇发病率 (SMM) 风险之间的关联.
- 确定特定的医院特征,如位置和床位大小,可能会加剧这种风险.
主要方法:
- 利用了国家医疗保险服务2005-2019年韩国分娩的大量数据集.
- 使用美国疾病控制和预防中心开发的算法来定义SMM.
- 进行了经过修改的Poisson回归分析,按医院地区和床位数进行分层,以评估非定时分娩和SMM之间的关联.
主要成果:
- 在超过300万名无产妇中,大约32.7%的妇女在工作时间外分娩,其中2.6%的妇女经历了SMM.
- 夜间分娩 (周日和周末) 与SMM风险更高相关 (aRR 1.40-1.41).
- 在夜间分娩期间,SMM的风险在位于小城市的医院和100-499张床位的医院 (aRR在1.46至1.83之间) 特别高.
结论:
- 夜间分娩独立地与严重孕产妇发病率的风险增加有关.
- 在较小的区域医院中,产妇护理质量和下班时间的患者安全可能会受到损害.
- 需要有针对性的干预措施和资源配置,以减轻与非定时分娩相关的SMM风险,特别是在脆弱的医院环境中.
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