严重孕产妇发病风险与孕产妇并发病负担和社会脆弱性相关
Moti Gulersen1,2, Alejandro Alvarez3, Fernando Suarez1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital - Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
American journal of perinatology
|December 6, 2023
概括
产科并发症指数 (OB-CMI) 与严重的孕产妇发病率 (SMM) 有关,较高的得分增加了风险. 在OB-CMI组内存在SMM的种族差异,而社会脆弱性指数 (SVI) 显示没有关联.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
背景情况:
- 严重的孕产妇发病率 (SMM) 构成了重大的公共卫生挑战.
- 确定SMM的预测因素对于有针对性的干预措施至关重要.
- 产科并发症指数 (OB-CMI) 和社会脆弱性指数 (SVI) 是SMM风险的潜在指标.
研究的目的:
- 评估产科并发症指数 (OB-CMI) 和社会脆弱性指数 (SVI) 与严重孕产妇发病率 (SMM) 之间的关联.
- 调查这些指数与母亲特征之间的潜在相互作用.
- 在多样化的患者群体中识别导致SMM的风险因素.
主要方法:
- 2019年1月至2021年12月期间73518次分娩的多中心回顾性队列研究.
- 根据临床文档和诊断代码分配的OB-CMI分数.
- 根据人口普查数据分配的SVI分数;SMM由21个CDC指标定义.
- 混合效应物流回归用于建模SMM赔率,调整种族,种族,保险,语言和平等.
主要成果:
- 在OB-CMI和SMM之间发现了显著的关联 (p < 0.001),增加的OB-CMI类别与更高的SMM概率相关.
- 观察到OB-CMI与母亲的种族/种族之间存在显著的相互作用 (p = 0.01).
- 与得分较低的非西班牙裔白人患者相比,非西班牙裔黑人患者的OB-CMI得分较高的SMM几率显著更高 (aORs从2.76到10.07).
- 在调整后的分析中,社会脆弱性指数 (SVI) 与SMM没有显著的关联.
结论:
- 产科并发症指数 (OB-CMI) 是严重孕产妇发病率 (SMM) 的重要预测指标.
- 在不同OB-CMI得分类别中,SMM风险的种族差异很明显,突出了对文化敏感护理的需求.
- 在调整了混因素后,社会脆弱性指数 (SVI) 并没有成为该队列中SMM的独立预测指标.
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