患有风湿性心脏病的孕妇结果的全球差异:一个范围审查
Jenny M Yang1,2, Natalie Tchakerian3, Candice K Silversides4
1Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
怀孕期间的风湿性心脏病 (RHD) 导致由于社会经济和医疗保健准入问题导致结果不佳. 解决预防,诊断和护理差异对于改善RHD患者的母亲健康至关重要.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 公共卫生
背景情况:
- 风湿性心脏病 (RHD) 是全球间接妊娠相关死亡率和发病率的重要原因.
- RHD对边缘化人口产生了不成比例的影响,加剧了健康差距.
- 了解导致RHD妊娠不良结果的因素至关重要.
研究的目的:
- 探索社会经济,文化和医疗保健准入因素,这些因素导致了RHD患者怀孕结果的全球差异.
- 在被诊断患有RHD的孕妇中确定不同结果的关键决定因素.
主要方法:
- 对1990年1月1日至2022年1月1日期间发表的研究进行了全面的文献搜索.
- 审查的重点是确定怀孕个体与RHD.不同结果的原因.
- 从最初的3,544篇文章中,最终分析包括了16篇研究.
主要成果:
- 导致不同结果的关键因素包括缺乏RHD的二次抗生素预防.
- 确定了晚期和更严重的RHD诊断,差异化管理和产前护理准入.
- 缺乏专业的多学科护理,患者教育,RHD药物,干预,手术和有限的财务资源是重要的障碍.
结论:
- 这些发现突出了影响RHD患者怀孕结果的因素的复杂相互作用.
- 一个终身的方法揭示了有针对性的临床和公共卫生干预的机会.
- 干预措施应侧重于改善预防,诊断,护理,教育和资源分配.
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