Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017.
Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017.
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DOI：
10.2105/ajph.2021.306375
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发表时间：
2021-09
影响因子：
12.7
通讯作者：
Howell EA
中科院分区：
文献类型：
--
作者：
MacDorman MF;Thoma M;Declcerq E;Howell EA
更好地了解美国孕产妇死亡率的种族和民族差异。我们分析了2016-2017年的生命统计死亡率数据，并添加了死因文字（死亡证明上的实际文字）。我们创建了一个已确认的孕产妇死亡子集，其中在死亡原因文字中提到了妊娠。确定主要死因，并使用死因文字进行重新编码。对种族和民族差异进行了全面和主要原因的审查。非西班牙裔黑人妇女的孕产妇死亡率是非西班牙裔白色妇女的3.55倍。非西班牙裔黑人妇女孕产妇死亡的主要原因是子痫/先兆子痫和产后心肌病，其发生率是非西班牙裔白色妇女的5倍。非西班牙裔黑人产妇产科栓塞和产科出血死亡率是非西班牙裔白色妇女的2.3-2.6倍。这四个原因加在一起占非西班牙裔黑人/非西班牙裔白色产妇死亡率差异的59%。心血管相关疾病在确认的孕产妇死亡的主要原因中的突出地位，特别是对于非西班牙裔黑人妇女，需要在怀孕/产后期间提高对心血管问题的警惕。其中许多死亡是可以预防的。
To better understand racial and ethnic disparities in US maternal mortality. We analyzed 2016–2017 vital statistics mortality data with cause-of-death literals (actual words written on the death certificate) added. We created a subset of confirmed maternal deaths which had pregnancy mentions in the cause-of-death literals. Primary cause of death was identified and recoded using cause-of-death literals. Racial and ethnic disparities were examined both overall and by primary cause. The maternal mortality rate for non-Hispanic Black women was 3.55 times that for non-Hispanic White women. Leading causes of maternal death for non-Hispanic Black women were eclampsia/preeclampsia and postpartum cardiomyopathy with rates 5 times those for non-Hispanic White women. Non-Hispanic Black maternal mortality rates from obstetric embolism and obstetric hemorrhage were 2.3–2.6 times those for non-Hispanic White women. Together these four causes accounted for 59% of the non-Hispanic Black/non-Hispanic White maternal mortality disparity. The prominence of cardiovascular-related conditions among the leading causes of confirmed maternal death, particularly for non-Hispanic Black women, necessitates increased vigilance for cardiovascular problems during the pregnant/postpartum period. Many of these deaths are preventable.