安大略省分娩后死亡率:20年时间趋势和原因分析
Ann E Sprague1, Nicole F Roberts1, Carolina Lavin Venegas1
1Better Outcomes Registry and Network (BORN), Ottawa, ON, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
|October 14, 2024
概括
产后一年内产妇死亡通常是可以预防的. 这项研究发现,虽然早期死亡与怀孕有关,但晚期死亡通常是由于其他原因造成的,这凸显了全面监测的必要性.
科学领域:
- 公共卫生 公共卫生
- 产科和妇科 产科和妇科
- 流行病学 流行病学
背景情况:
- 孕产妇死亡监测对于预防至关重要,但了解长期原因仍然是一个挑战.
- 准确的孕产妇死亡率数据对于制定有效的公共卫生干预措施至关重要.
研究的目的:
- 在安大略省20年的时间内检查母亲死亡的数量和原因.
- 区分早期 (42天内) 和晚期 (43-365天) 的孕产妇死亡及其相关原因.
主要方法:
- 一项回顾性队列研究分析了2002年至2022年在加拿大安大略省的医院活产和死产.
- 来自加拿大卫生信息研究所和国家门诊护理系统的数据与出生记录联系在一起.
- 在产后365天内发生的死亡被至少3名临床医生识别和审查.
主要成果:
- 在20年间,每10万例出生的孕产妇死亡率 (MMR) 为17.5 (485例死亡).
- 早期死亡 (n=222) 的MMR为8.0/100,000,主要是由于出血,感染,孕前和肺栓塞.
- 晚期死亡 (n=263) 的MMR为9.5/100,000,癌症,损伤和心脏骤停是主要原因.
结论:
- 大多数在产后一年内发生的孕产妇死亡并不是直接产科原因,但怀孕并发症显著影响过早死亡.
- 早期和晚期孕产妇死亡的不同原因需要在分娩后的时间之外进行更广泛的监测.
- 医院外或怀孕早期死亡报告不足可能导致对总体孕产妇死亡率的低估.
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