母胎医学医生密度与怀孕结果之间的关联
Tetsuya Kawakita1,2, Rula Atwani1, Misa Hayasaka1
1EVMS Department of Obstetrics and Gynecology, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, Virginia, United States.
American journal of perinatology
|October 8, 2025
概括
较高的母胎医学 (MFM) 医生密度与较低的孕产妇和妊娠相关死亡率有关. 增加MFM接入可能会减少不良结果,特别是在服务不足的地区.
科学领域:
- 围产期健康 围产期健康
- 公共卫生政策 公共卫生政策
- 获得医疗保健 获得医疗保健 获得医疗保健
背景情况:
- 孕产妇死亡率在美国仍然是一个重大的公共卫生问题.
- 在获得医疗保健方面的差异,包括专家的可用性,可能会导致不良的妊娠结果.
- 母胎医学 (MFM) 专家在管理高风险怀孕方面发挥着至关重要的作用.
研究的目的:
- 在州一级调查母胎医学 (MFM) 医生密度和不良妊娠结果之间的关联.
- 为了确定更高的MFM医生密度是否与降低的孕产妇死亡率,与怀孕有关的死亡率和死产率相关.
- 通过专业分发,为旨在改善孕产妇健康结果的公共卫生战略提供信息.
主要方法:
- 对2018-2021年国家级数据的横截面分析,包括出生率,多种死亡原因和胎儿死亡数据库.
- 暴露:每个州的MFM医生密度,分为低 (<30),中等 (30-59) 或高 (≥60每10万活产).
- 结果:产妇死亡率,与怀孕有关的死亡率和死产. 使用多变量负双项混合效应回归模型进行统计分析.
主要成果:
- 与密度较低的国家相比,MFM密度较高的国家的孕产妇死亡率 (aIRR:0.70) 和与怀孕有关的死亡率 (aIRR:0.83) 的风险较低.
- 高MFM密度相当于每10万活产婴儿的孕产妇死亡人数减少约7.29,妊娠相关死亡人数减少5.57.
- 与低密度州相比,中度MFM密度州在孕产妇死亡风险上没有显示出统计学上显著的差异.
结论:
- 较高的孕产妇医生密度与降低孕产妇和妊娠相关死亡率有关.
- 增加MFM医生的可用性,特别是在服务不足的地区,可能是减少孕产妇死亡率的关键策略.
- 这些发现强调了公平分配MFM专家的重要性,以改善国家产妇健康结果.
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