Perinatal care in Portugal: Effects of 15 years of a regionalized system
Perinatal care in Portugal: Effects of 15 years of a regionalized system
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DOI：
10.1080/08035250600615135
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发表时间：
2006-11-01
期刊：
影响因子：
3.8
通讯作者：
Neto, Maria Teresa
中科院分区：
文献类型：
--
作者：
Neto, Maria Teresa
目的：分享葡萄牙围产期保健组织的信息。方法：数据来源于1989年全国母婴健康委员会方案、国家统计研究所和欧盟统计局。结果：1989年，葡萄牙对围产期保健进行了改革：建议关闭每年分娩次数少于1500次的产科病房；将医院划分为I级(无分娩)、II级(低风险分娩、中间监护病房)或III级(高风险分娩、重症监护病房)，并设立了负责地方卫生中心与医院之间联络的职能协调单位。1987年开始在全国范围内建立新生儿转运系统，并于1990年开办了新生儿学研究生课程。有了这项改革，住院分娩从改革前的74%增加到改革后的99%。孕产妇死亡率从1989年的9.2/10万降至2003年的5.3，同期围产期死亡率从16.4降至6.6/1000(活产+死胎，胎龄=22周)，新生儿死亡率从8.1降至2.7/1000，婴儿死亡率从12.2/1000降至4/1000。
Aim: To share information on the organization of perinatal care in Portugal. Methods: Data were derived from the Programme of the National Committee for Mother and Child Health 1989, National Institute for Statistics, and Eurostat. Results: In 1989, perinatal care in Portugal was reformed: the closure was proposed of maternity units with less than 1500 deliveries per year; hospitals were classified as level I (no deliveries), II (low-risk deliveries, intermediate care units) or III (high-risk deliveries, intensive care units), and functional coordinating units responsible for liaison between local health centres and hospitals were established. A nationwide system of neonatal transport began in 1987, and in 1990 postgraduate courses on neonatology were initiated. With this reform, in-hospital deliveries increased from 74% before the reform to 99% after. Maternal death rate decreased from 9.2/100 000 deliveries in 1989 to 5.3 in 2003 and, in the same period, the perinatal mortality rate decreased from 16.4 to 6.6/1000 (live births + stillborn with >= 22 wk gestational age), the neonatal mortality rate decreased from 8.1 to 2.7/1000 live births, and the infant mortality rate from 12.2/1000 live births to 4/1000.