在分娩期间的外周止痛和严重的孕产妇发病率:基于人口的研究
Rachel J Kearns1,2, Aizhan Kyzayeva2, Lucy O E Halliday2
1Department of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK rachel.kearns@glasgow.ac.uk.
概括
在分娩期间的外周止痛可显著减少35%的严重孕产妇发病率 (SMM). 这些好处在有医疗指示的妇女和早产妇女中更为明显,这表明扩大接入可以改善母亲的健康.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 公共卫生 公共卫生
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.
- 外周止痛药通常用于减轻分娩期间的疼痛.
- 外围止痛对SMM的具体影响,特别是在高风险群体中,需要进一步阐明.
研究的目的:
- 为了确定产后外周止痛对严重孕产妇发病率 (SMM) 的影响.
- 为了探索这种效应是否在患有外周止痛治疗医疗指示的妇女或经历过早产的妇女中更明显.
主要方法:
- 一项以人口为基础的研究使用了来自苏格兰所有NHS医院的数据.
- 包括567216名从2007年至2019年怀孕24+0至42+6周之间的分娩妇女.
- 根据CDC的标准或产后42天内接受重症监护的入院,SMM被定义为SMM.
主要成果:
- 外周止痛与SMM减少35% (aRR为0.65) 有关.
- 在患有外周止痛治疗医疗征兆的妇女 (aRR 0.50) 和早产妇女 (aRR 0.53) 中,观察到更大的风险降低.
- 外周止痛对SMM的保护作用随着出生时妊娠年龄的降低而增加.
结论:
- 产后外周止痛与严重的孕产妇发病率显著降低有关.
- 在有医疗指示的妇女和早产妇女中,益处更为明显.
- 扩大对外周止痛的准入,特别是对高风险人群,可能会改善孕产妇的健康结果.
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