世界卫生组织关于基本分娩实践和围产期死亡率的安全分娩清单:元分析
Lennart Christian Kaplan1, Megan Marx Delaney2, Pia Roddewig3
1Georg-August-University of Göttingen, Göttingen, Germany.
JAMA network open
|February 26, 2026
概括
世界卫生组织的安全分娩检查清单 (SCC) 改善了对基于证据的实践 (EBP) 的遵守. 虽然总体死亡率没有变化,但在中低收入国家观察到的期间,SCC使用与死亡出生率的减少有关.
科学领域:
- 全球健康 全球健康
- 孕产妇和新生儿的健康
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 世界卫生组织 (WHO) 的安全分娩检查清单 (SCC) 在全球范围内实施,以加强产科护理.
- 之前的研究表明,随着SCC实施,对实践的坚持增加了,但结果在不同环境中不同.
研究的目的:
- 调查SCC实施与死亡率之间的关联.
- 分析SCC对遵守基于证据的实践 (EBP) 的影响.
主要方法:
- 2014年至2017年间在印度,印度尼西亚和巴基斯坦进行的SCC3个集群随机试验的元分析.
- 使用治疗意图 (ITT) 和复合平均因果效应 (CACE) 分析来估计对EBP和围产死亡率的影响.
- 主要结局包括死产,围产和新生儿早期死亡率;次要结局侧重于EBP遵守和设施条件.
主要成果:
- 干预组和对照组之间的总死亡率没有显著差异.
- 在EBP观察期间,SCC干预设施的死产率明显较低 (ITT: -9.8/1000分娩;CACE: -14.5/1000分娩).
- SCC的实施导致EBP遵守率大幅增加 (ITT: +3.6实践;CACE: +6.0实践).
结论:
- 在中低收入群体中,SCC使用与更好地遵守EBP有关.
- SCC显示,死亡出生率有所降低,特别是当EBP受到密切监测时.
- 建议进行进一步的研究,以优化SCC对母亲和新生儿安全的影响.
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