美国产妇死亡率的时空空间模式和监测人工物:基于人口的研究
K S Joseph1,2, Sarka Lisonkova1,2, Amélie Boutin3
1Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, Canada.
Lancet regional health. Americas
|October 21, 2024
概括
美国的孕产妇死亡率 (MMR) 已经上升,增加的原因不太具体,特别是在高MMR州. 这表明,在某些地区,可能存在错误的分类和对孕产妇死亡率的高估.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 孕产妇健康 孕产妇健康
背景情况:
- 美国不断上升的孕产妇死亡率 (MMR) 是一个重大的公共卫生问题.
- 了解导致这种趋势的具体原因对于有效干预至关重要.
研究的目的:
- 为了检查在美国特定原因的MMRs的时空模式.
- 确定导致观察到孕产妇死亡人数增加的因素.
主要方法:
- 从疾病控制和预防中心 (CDC) 1999年至2021年间对产妇死亡数据的分析.
- 量化全国的整体和特定原因的MMR变化,按州的MMR水平 (低高),以及加利福尼亚和德克萨斯州之间的变化.
- 原因分为明确的产科原因和不太具体的/潜在的偶然原因.
主要成果:
- 总的来说,MMRs从1999-2002年的9.60大幅增加到2018-2021年每10万活产婴儿中的23.5个.
- 在高MMR状态下,MMR的增加比低MMR状态更明显.
- 虽然明确的产科原因显示了类似的趋势,但不太具体/潜在的偶然原因的增加在各州之间有很大的差异,这表明潜在的错误分类.
结论:
- 时空分析显示,孕产妇死亡的不太具体/潜在的偶然原因的增加是MMR上升的关键驱动因素.
- 加利福尼亚和德克萨斯等州之间这些不太具体的原因的变化表明,在某些地区,可能存在错误分类和对孕产妇死亡率的高估.
- 解决母亲死亡报告中的潜在错误分类对于准确的评估和有针对性的干预措施至关重要.
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