高收入环境中的严重孕产妇死亡率:综合定义的系统审查
Ian Henderson1, Rosie Lynch1, Stephen Gerry2
1National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.
EClinicalMedicine
|March 4, 2025
概括
严重孕产妇发病率的定义差异很大,阻碍了全球对产妇护理质量的比较. 协调数据来源和组件对于提高国际可比性和孕产妇健康结果至关重要.
科学领域:
- 孕产妇健康 孕产妇健康
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 严重孕产妇发病率 (SMM) 是评估和改善产妇护理质量的关键指标.
- 目前用于测量SMM的方法表现出显著的差异,阻碍了全球比较和基准测试.
- 了解SMM定义的多样性对于提高流行病学研究的可靠性至关重要.
研究的目的:
- 系统地审查和分析流行病学实践中使用的各种严重孕产妇发病率 (SMM) 定义.
- 在不同的医疗保健环境中识别SMM定义之间的共同组成部分和变异来源.
- 为协调SMM定义提供建议,以促进全球比较.
主要方法:
- 在PubMed,Embase和Google Scholar进行了系统的文献搜索,寻找从1993年到2024年的SMM定义.
- 包括的研究重点是对怀孕期间或产后六周内SMM的综合性综合定义.
- 根据使用的临床概念,诊断代码和程序代码进行了定义比较.
主要成果:
- 搜索确定了40项研究,报告了行政数据的32个定义 (中位数发生率11.4/1000) 和初级医疗记录的13个定义 (中位数发生率6.7/1000).
- 通常包括的疾病包括心脏,呼吸道,功能障碍,出血,血栓,感染和关键干预,输血在高达75%的病例中具有重要意义.
- 产科诊断的选择和定义以及所需的额外数据来源存在显著差异,限制了可比性.
结论:
- 尽管有共同点,但SMM定义存在很大差异,影响了发病率和病例组成.
- 没有两个行政数据定义在发病率,组件或组件分布上相似.
- 建议对SMM定义的目的,组成代码和数据源进行协调,以便在全球范围内进行孕产妇系统之间的有意义的比较.
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