Maternal mortality in Ifakara Health and Demographic Surveillance System: Spatial patterns, trends and risk factors, 2006 - 2010.
Maternal mortality in Ifakara Health and Demographic Surveillance System: Spatial patterns, trends and risk factors, 2006 - 2010.
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DOI：
10.1371/journal.pone.0205370
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Nelson G
中科院分区：
文献类型：
--
作者：
Manyeh AK;Nathan R;Nelson G
孕产妇死亡率是联合国第五个千年发展目标的主题，即从1990年到2015年将孕产妇死亡率降低四分之三。可持续发展目标（SDG）的具体目标3.1要求参与国到2030年将孕产妇死亡率降至每10万活产70例以下。虽然已经进行了大量研究，但了解与发展中国家孕产妇死亡率有关的空间模式和风险因素有助于将稀缺资源和干预方案用于高风险地区，以产生最大影响。分析了2006年至2010年招募的15至49岁女性纵向开放队列的数据。采用距离加权反比插值法评估孕产妇死亡率的空间格局。采用考克斯比例风险回归分析确定与孕产妇死亡相关的危险因素。36792名研究参与者五年的总体孕产妇死亡率为每1000人年0.79人。这一趋势从2006年的90.42下降到2010年的57.42。产妇死亡率模式存在明显的地域差异。产妇死亡的主要原因是子痫（23%）、大出血（22%）和与堕胎有关的并发症（10%）。与20岁以下的女性相比，20-29岁和30-39岁的女性的风险分别降低了82%（HR = 0.18，95% CI：0.05-0.74）和78%（HR = 0.22，95% CI：0.05-0.92）。与单身相比，已婚妇女的保护作用为94%（HR = 0.06，95%CI：0.01-0.51），丧偶妇女的孕产妇死亡风险增加了913%（HR = 9.13，95%CI：1.02-81.94）。与最贫穷类别的妇女相比，属于较贫穷、贫穷和最不贫穷社会经济五分位数的妇女的孕产妇死亡风险分别降低了84%、71%和72（HR = 0.16，95% CI：0.06-0.42; HR = 0.29，95% CI：0.12-0.69; HR = 0.28，95% CI：0.10-0.80）。自2006年以来，坦桑尼亚南部农村地区的孕产妇死亡率有所下降，但死亡模式存在地域差异。子痫、大出血和与堕胎有关的并发症是该区域孕产妇死亡的三大主要原因，风险因素包括20岁以下、单身或丧偶以及社会经济地位低下。
Maternal mortality was the subject of the United Nations’ fifth Millennium Development Goal which was to reduce the maternal mortality ratio by three quarters from 1990 to 2015. The Sustainable Development Goals (SDGs), target 3.1 requires participating countries to reduce their maternal mortality ratio to less than 70 deaths per 100,000 live births by 2030. Although much research has been conducted, knowing the spatial patterns and risk factors associated with maternal mortality in developing countries helps target scarce resources and intervention programmes to high risk areas for the greatest impact. Data were analysed from a longitudinal open cohort of women aged 15 to 49 years, enrolled from 2006 to 2010. An inverse distance weighted method of interpolation was used to assess spatial patterns of maternal mortality. Cox proportional hazards regression analysis was used to identify risk factors associated with maternal mortality. The overall maternal mortality rate for the 36 792 study participants for the five years was 0.79 per 1000 person years. The trend declined from 90.42 in 2006 to 57.42 in 2010. Marked geographical differences were observed in maternal mortality patterns. The main causes of maternal death were eclampsia (23%), haemorrhage (22%) and abortion-related complications (10%). There was a reduced risk of 82% (HR = 0.18, 95% CI:0.05–0.74) and 78% (HR = 0.22, 95% CI:0.05–0.92) for women aged 20–29 and 30–39 years, respectively, compared with those younger than 20 years. While being married had a protective effect of 94% (HR = 0.06, 95% CI: 0.01–0.51) compared with being single, women who were widowed had an increased risk of maternal death of 913% (HR = 9.13, 95% CI: 1.02–81.94). Women who belong to poorer, poor and least poor socioeconomic quintile had 84%, 71% and 72% reduction in risk of maternal mortality respectively compared to those in the poorest category (HR = 0.16, 95% CI: 0.06–0.42; HR = 0.29, 95% CI: 0.12–0.69; HR = 0.28, 95% CI: 0.10–0.80). Maternal mortality has declined in rural southern Tanzania since 2006, with geographical differences in patterns of death. Eclampsia, haemorrhage and abortion-related complications are the three leading causes of maternal death in the region, with risk factors being younger than 20 years, being single or widowed, and having a low socioeconomic status.
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影响因子：
1
作者：
Garenne, M;Mbaye, K;Correa, P
通讯作者：
Correa, P
影响因子：
168.9
作者：
Kassebaum, N. J.;Bertozzi-Villa, A.;Coggeshall, M. S.
通讯作者：
Coggeshall, M. S.
影响因子：
6.3
作者：
KRIEGER, N
通讯作者：
KRIEGER, N
影响因子：
3.2
作者：
Kongnyuy, Eugene J.;Mlava, Grace;van den Broek, Nynke
通讯作者：
van den Broek, Nynke
影响因子：
0.9
作者：
Kullima, Abubakar Ali;Kawuwa, Mohammed Bello;Mairiga, Abdulkarim G.
通讯作者：
Mairiga, Abdulkarim G.