2009-20年全球和地区产妇死亡原因:世卫组织系统分析
Jenny A Cresswell1, Monica Alexander2, Michael Y C Chong3
1UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development, and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland.
The Lancet. Global health
|March 10, 2025
概括
由于出血而导致的孕产妇死亡率仍然很高,这凸显了改善医疗保健准入的必要性. 大多数死亡发生在产后,强调改善产后护理与产后干预一起.
科学领域:
- 全球卫生健康 全球卫生健康
- 产科和妇科的产科和妇科.
- 公共卫生政策 公共卫生政策
背景情况:
- 孕产妇死亡率是一个关键的全球卫生问题,目前的趋势不符合可持续发展目标 (SDG) 目标3.1.
- 关于产妇死亡原因的最新证据对于加速全球减少产妇死亡率的进展至关重要.
研究的目的:
- 系统地审查和估计全球和可持续发展目标地区的孕产妇死亡原因的分布.
- 提供有关孕产妇死亡的主要原因的最新证据,以告知干预措施.
主要方法:
- 针对2009年至2020年间的孕产妇死亡情况,进行了一项多策略系统审查.
- 数据来源包括世卫组织死亡数据库,国家报告和文献数据库.
- 用贝叶斯的层次模型来估计特定原因的孕产妇死亡分布,并对自杀和晚期孕产妇死亡进行了额外的分析.
主要成果:
- 在全球范围内,出血是孕产妇死亡的主要原因 (27%),其次是间接产科原因 (23%) 和高血压疾病 (16%).
- 观察到区域差异,撒哈拉以南非洲和西亚/北非的出血率最高,拉丁美洲和加勒比海的高血压障碍.
- 大多数由出血和败血症引起的孕产妇死亡发生在分娩后. 孕产妇自杀和晚期孕产妇死亡占总孕产妇死亡人数的比例较小.
结论:
- 流血仍然是孕产妇死亡的主要原因,强调需要改善获得优质医疗保健的机会.
- 产后死亡的高发病率需要加强产后护理策略.
- 解决孕产妇死亡率的间接原因需要综合卫生系统方法,将产科和非产科护理结合起来.
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