Maternal morbidity and mortality associated with interpregnancy interval:: cross sectional study
Maternal morbidity and mortality associated with interpregnancy interval:: cross sectional study
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DOI：
10.1136/bmj.321.7271.1255
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发表时间：
2000-11-18
影响因子：
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通讯作者：
Belizán, JM
中科院分区：
文献类型：
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作者：
Conde-Agudelo, A;Belizán, JM
目的研究分娩间隔对产妇发病率和死亡率的影响。采用乌拉圭蒙得维的亚拉丁美洲围产期和人类发展中心围产期信息系统数据库中的数据进行回顾性横断面研究。研究对象为拉丁美洲和加勒比地区，1985-97年。受试者为456889名分娩单胎的产妇。主要观察指标为分娩间隔短和长对产妇死亡、妊娠晚期出血、胎膜早破、产后出血、产后子宫内膜炎和贫血的影响的粗略和调整的优势比。结果分娩间隔短(59个月)的妇女分别占2.8%和19.5%。调整主要混杂因素后，分娩间隔小于等于5个月的产妇死亡(优势比2.54；95%可信区间1.22~5.38)、妊娠晚期出血(1.73；1.42~2.24)、胎膜早破(1.72；1.53~1.93)、产后子宫内膜炎(1.33；1.22~1.45)和贫血(1.30；1.18~1.43)的风险较高。与口译间隔18~23个月的妇女相比，口译间隔超过59个月的妇女患先兆子痫(1.83；1.72~1.94)和子痫(1.80；1.38~2.32)的风险显著增加。结论口译间隔<6个月和>59个月与不良母亲结局的风险增加有关。
Objective To study the impact of interpregnancy interval on maternal morbidity and mortality.Design Retrospective cross sectional study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay.Setting Latin America and the Caribbean, 1985-97.Participants 456 889 parous women delivering singleton infants.Main outcome measures Crude and adjusted odds ratios of the effects of short and long interpregnancy intervals on maternal death, third trimester bleeding, premature rupture of membranes, postpartum haemorrhage, puerperal endometritis, and anaemia.Results Short ( 59 months) interpregnancy intervals were observed for 2.8% and 19.5% of women, respectively. After adjustment for major confounding factors, compared with those conceiving at 18 to 23 months after a previous birth, women with interpregnancy intervals of 5 months or less had higher risks for maternal death (odds ratio 2.54; 95% confidence interval 1.22 to 5.38), third trimester bleeding (1.73; 1.42 to 2.24), premature rupture of membranes (1.72; 1.53 to 1.93), puerperal endometritis (1.33; 1.22 to 1.45), and anaemia (1.30; 1.18 to 1.43). Compared with women with interpregnancy intervals of 18 to 23 months, women with interpregnancy intervals longer than 59 months had significantly increased risks of pre-eclampsia (1.83; 1.72 to 1.94) and eclampsia (1.80; 1.38 to 2.32).Conclusions Interpregnancy intervals less than 6 months and longer than 59 months are associated with an increased risk of adverse maternal outcomes.