改变死胎定义对评估产前死亡率的影响
1Department of Child Health, University of Wales College of Medicine, Cardiff, UK.
Lancet (London, England)
|August 19, 1995
概括
修订后的围产期死亡率定义,包括早期怀孕,更好地反映了围产期护理的有效性. 然而,如果排除出生时体重非常低的婴儿 (低于500克),并包括晚期新生儿死亡,将提高它的效用.
科学领域:
- 围产儿医学 围产儿医学
- 公共卫生统计 公共卫生统计
- 新生儿护理评估新生儿护理
背景情况:
- 产周死亡率 (PMR) 是评估产周护理质量的关键指标.
- 1992年英国的一项法律变更重新定义了死胎,包括从怀孕24-27周的胎儿死亡,改变了PMR的定义.
- 这个修订后的定义在衡量护理质量的有效性需要评估.
研究的目的:
- 评估更新的围产死亡率定义是否更准确地反映了围产护理的有效性.
- 分析包括早期怀孕和出生时体重非常低的婴儿对PMR的影响.
主要方法:
- 对1993年威尔士居民妇女所有分娩的队列分析.
- 在PMR计算中包括从怀孕24-27周出生的死胎.
- 在围产期内分析婴儿存活率,死亡率和出生体重 (低于500克).
主要成果:
- 这项研究包括了36793例分娩和313例产前死亡.
- 在怀孕24-27周出生的婴儿显示显著的生存率 (39%) 和死亡率 (93人死亡).
- 排除500克以下的婴儿,包括晚期新生儿死亡 (所有与产周相关的) 将完善PMR的实用性.
结论:
- 包括怀孕24-27周出生的婴儿对于准确反映围产死亡率至关重要.
- 现在的PMR定义可以通过排除出生体重低于500克的婴儿来加强.
- 将晚期新生儿死亡纳入PMR将提供一个更全面的衡量围产期护理有效性的方法.
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