识别严重孕产妇发病群的新方法:潜伏类分析
Andrea J Ibarra1, Samia H Lopa2, BaDoi N Phan3
1Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
American journal of perinatology
|October 8, 2024
概括
严重的孕产妇发病率 (SMM) 包括危及生命的疾病. 这项研究确定了四个不同的SMM集群:出血,重症监护,血管和冲击,每个对母亲和婴儿都有独特的风险和结果.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 公共卫生 公共卫生
背景情况:
- 严重的孕产妇发病率 (SMM) 涵盖了一系列危及生命的疾病,使怀孕和分娩复杂化.
- 了解SMM的异质性对于有针对性的干预和改善结果至关重要.
- 之前的研究并没有明确地确定SMM内部的不同集群.
研究的目的:
- 通过数据驱动的方法来识别严重孕产妇发病率 (SMM) 的不同集群.
- 确定与每个SMM集群相关的预测因素.
- 分析每个已识别的SMM集群的孕产妇和新生儿结局.
主要方法:
- 隐性类型建模应用于2008-2017年的交付数据库,包括状态数据和医疗记录.
- 该分析纳入了23个由CDC SMM指标定义的条件,ICU入院和延长产后停留时间.
- 使用后勤回归模型来评估风险和集群与结果之间的关联.
主要成果:
- 在97,492个交付中,总共有2.7%的交付经历了SMM.
- 确定了四个不同的SMM集群:出血 (37.7%),重症监护 (28.1%),血管 (24.5%) 和冲击 (9.8%).
- 冲击集群与妊娠高血压疾病,抑郁症和医疗补助保险有关;所有集群都显示孕产妇死亡风险增加,而冲击集群的婴儿面临新生儿死亡和并发症的最高风险.
结论:
- 已经确定了四种新型的严重孕产妇发病率群 (出血,重症监护,血管,冲击).
- 这些集群提供了对潜在途径的见解,以及抑郁症和健康的社会决定因素等并发症的影响.
- 不同的SMM集群存在对孕产妇和新生儿不良结果的不同风险,突出显示了需要量身定制的护理.
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