在怀孕期间使用紧急护理和严重的孕产妇发病率
Eugene R Declercq1, Chia-Ling Liu2, Howard J Cabral1
1Boston University School of Public Health, Boston, Massachusetts.
JAMA network open
|October 16, 2024
概括
怀孕期间经常去急诊的孕妇面临更高的严重孕产妇死亡率 (SMM) 风险. 建议为这个弱势群体提供综合,社区化的护理.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在怀孕期间重复使用紧急护理表明潜在的脆弱性和严重孕产妇发病率 (SMM) 的风险增加.
- 了解非计划护理的模式对于识别风险人群和制定有针对性的干预措施至关重要.
研究的目的:
- 为了调查怀孕期间非预定医疗保健访问的模式.
- 确定频繁的非计划性护理使用与出生时SMM的发生之间的联系.
主要方法:
- 一项队列研究利用了马萨诸塞州从2002年10月到2020年3月的全州医院记录.
- 包括经历出生或胎儿死亡的孕妇,分析急诊室访问或观察期间作为暴露.
- 严重的孕产妇发病率 (SMM) 是主要结局,由20个ICD编码的条件/程序定义.
主要成果:
- 这项研究包括774,092名孕妇;3.3%的孕妇有4次或更多的非计划性访问.
- 在年轻人,西班牙裔和黑人人口中,那些有公共保险,并发症或先前使用阿片类药物的人中,频繁的非计划性访问更为常见.
- 与那些没有访问的人相比,有4次或更多的非计划访问的个人对SMM有1.46的调整几率比率.
结论:
- 怀孕期间急救护理的高利用率与严重孕产妇发病率的风险增加有关.
- 有相当数量的经常进行非预定访问的个人也使用了多家医院,突出了协调护理的必要性.
- 基于社区的综合卫生系统解决方案对于应对经常使用紧急护理的孕妇的需求至关重要.
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