2018-2023年美国各州的孕产妇死亡率趋势
Lauren M Rossen1, Donna L Hoyert2, Isabelle Horon2
1Division of Research and Methodology, National Center for Health Statistics, CDC.
American journal of obstetrics and gynecology
|August 30, 2025
概括
美国孕产妇死亡率在2021年大幅上升,主要是由于COVID-19死亡,然后下降. 国家层面的分析显示出显著的差异,突出显示了大流行对孕产妇健康状况的影响.
科学领域:
- 公共卫生
- 流行病学
- 生物统计学
背景情况:
- 美国在2018年后的孕产妇死亡率上升,在2021年达到顶峰,随后在2022-2023年下降.
- 由于每个州的年死亡人数较少,此前没有对各州的孕产妇死亡率趋势进行研究.
- 小区域估计模型提供了一种可靠的州级孕产妇死亡率估计方法.
研究的目的:
- 分析从2018年到2023年的州级孕产妇死亡率趋势.
- 确定COVID-19相关死亡对这些产妇死亡趋势的贡献.
主要方法:
- 通过国家生命统计系统 (2018-2023) 的数据进行了连续的横截面研究.
- 包括4,964例产妇死亡和22,080,966例活产.
- 使用具有时空随机效应的等级贝叶斯模型进行了平滑的速率估计.
主要成果:
- 孕产妇死亡率在各州都出现了类似的趋势,在2021年达到顶峰,并在2022-2023年下降.
- 观察到州级的显著差异;例如,田纳西州的2021年率是加利福尼亚州的4.6倍.
- 大多数州的孕产妇死亡率增加的主要原因是COVID-19死亡.
结论:
- COVID-19 显著影响了各州的孕产妇死亡率趋势,几乎完全解释了 2020 年和 2021 年的增加.
- 结果可以指导高死亡率地区的有针对性的干预措施,并确定低死亡率地区的保护因素.
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