死产:意大利基于人口的试点监测系统 (SPItOSS) 的结果
Michele Antonio Salvatore1, Silvia Salvi1,2, Paola D'Aloja1
1National Centre for Disease Prevention and Health Promotion, Italian National Health Institute, Rome (Italy).
Epidemiologia e prevenzione
|May 21, 2024
概括
一个试点监测系统确定了外国国籍的母亲,多胎妊娠和使用辅助生殖技术的母亲的死产风险增加. 这突出了改善围产期护理的领域,并确定了可以避免的风险因素.
科学领域:
- 围产期流行病学 围产期流行病学
- 公共卫生监督 公共卫生监督
- 生殖医学 生殖医学
背景情况:
- 死产仍然是一个重要的全球健康问题,需要强大的监测系统来识别风险因素和原因.
- 了解母亲,产科和胎儿的特征对于开发有针对性的干预措施至关重要.
- 试点研究对于评估新监控方法的可行性和有效性至关重要.
研究的目的:
- 描述基于人口的试点围产期死亡率监测系统的结果,重点关注死胎.
- 调查与死产相关的孕产妇,产科和胎儿特征.
- 评估风险因素,了解死产的原因.
主要方法:
- 这是一项横截面研究,利用来自意大利三个地区 (2017年7月至2019年6月) 试点围产死亡率监测系统的数据.
- 包括通过使用重大事件审计方法的医院多学科审计确定的意外死产病例 (死亡出生>=28周怀孕的胎儿).
- 分析母亲特征,产科发现和胎儿数据,并使用世卫组织疾病-产前死亡率国际分类对死亡原因进行分类.
主要成果:
- 监测系统发现了520例死产,其中435例 (83.7%) 接受了多学科审计.
- 在具有外国国籍的母亲 (RR: 1.39),多胎妊娠 (RR: 1.59) 和通过辅助生殖技术怀孕的妇女 (RR: 2.15) 中观察到死产风险增加.
- 在6.0%的病例中存在先天性形,在10.3%的病例中存在胎儿生长限制;死后和胎盘检查分别在70%以上和90%的病例中进行.
结论:
- 基于人口的监测系统,具有高参与率和标准化定义,可以改善可避免的死产风险因素的识别.
- 这些发现突出了围产期护理改善的潜在领域,以及需要解决可修改的孕产妇状况.
- 有效的监测是减少死胎率和改善新生儿结果的关键.
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