Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades.
Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades.
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马萨诸塞州严重孕产妇发病率的趋势和不平等：最近二十年来仔细观察。
DOI：
10.1371/journal.pone.0279161
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Meadows, Audra
中科院分区：
文献类型：
--
作者：
Diop, Hafsatou;Declercq, Eugene R.;Liu, Chia-Ling;Cabral, Howard J.;Cui, Xiaohui;Amutah-Onukagha, Ndidiamaka;Meadows, Audra
据估计，在美国（US）有50，000 - 60，000名孕妇患有严重的孕产妇发病率（SMM）。SMM包括危及生命的疾病，如急性心肌梗死、急性肾衰竭、羊水栓塞、弥散性血管内凝血或败血症。先前的研究已经确定了2014年的增长率和SMM中的广泛种族差异。虽然减少孕产妇死亡和SMM在过去几十年一直是全球目标，但美国在实现这一目标方面取得的进展有限。我们的目标是检查1998-2018年的SMM趋势，以确定按种族/民族分类的导致SMM持续和上升的因素，并描述每种SMM疾病的黑人非西班牙裔/白色非西班牙裔比率。我们使用了一个基于人口的数据系统，将分娩记录与其相应的出院记录联系起来，以确定每10000例分娩的SMM率（不包括输血），并按种族/民族检查趋势。然后，我们分别对黑人和白色分娩人群进行分层分析。虽然在同一时期，所有种族/族裔群体的SMM率稳步上升，但与任何其他种族/族裔群体相比，黑人分娩人数的绝对增幅最大，从1998-2000年的69.4增加到2016-2018年的每10，000例分娩中的173.7。此外，我们发现，与白色分娩的人相比，黑人分娩的人在每种情况下的发病率都更高，手术期间心力衰竭的发病率比率从1.11到102.4不等。在黑人分娩人群中，肥胖与SMM无显著相关性，但在白色分娩人群中，肥胖与SMM相关[aRR 1.18（95% CI：1.02，1.36）]。对SMM如何影响不同种族/族裔群体的公正理解是改善孕产妇健康和预防SMM和黑人生育者死亡的关键。SMM需要作为医疗和公共卫生挑战加以解决。
It is estimated that 50,000–60,000 pregnant people in the United States (US) experience severe maternal morbidity (SMM). SMM includes life-threatening conditions, such as acute myocardial infarction, acute renal failure, amniotic fluid embolism, disseminated intravascular coagulation, or sepsis. Prior research has identified both rising rates through 2014 and wide racial disparities in SMM. While reducing maternal death and SMM has been a global goal for the past several decades, limited progress has been made in the US in achieving this goal. Our objectives were to examine SMM trends from 1998–2018 to identify factors contributing to the persistent and rising rates of SMM by race/ethnicity and describe the Black non-Hispanic/White non-Hispanic rate ratio for each SMM condition. We used a population-based data system that links delivery records to their corresponding hospital discharge records to identify SMM rates (excluding transfusion) per 10, 000 deliveries and examined the trends by race/ethnicity. We then conducted stratified analyses separately for Black and White birthing people. While the rates of SMM during the same periods steadily increased for all racial/ethnic groups, Black birthing people experienced the greatest absolute increase compared to any other race/ethnic group going from 69.4 in 1998–2000 to 173.7 per 10,000 deliveries in 2016–2018. In addition, we found that Black birthing people had higher rates for every individual condition compared to White birthing people, with rate ratios ranging from a low of 1.11 for heart failure during surgery to a high of 102.4 for sickle cell anemia. Obesity was not significantly associated with SMM among Black birthing people but was associated with SMM among White birthing people [aRR 1.18 (95% CI: 1.02, 1.36)]. An unbiased understanding of how SMM has affected different race/ethnicity groups is key to improving maternal health and preventing SMM and mortality among Black birthing people. SMM needs to be addressed as both a medical and public health challenge.
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DOI：
10.1097/phh.0000000000001297
发表时间：
2021-11-01
期刊：
Journal of public health management and practice : JPHMP
影响因子：
--
作者：
Gómez CA;Kleinman DV;Pronk N;Wrenn Gordon GL;Ochiai E;Blakey C;Johnson A;Brewer KH
通讯作者：
Brewer KH
DOI：
10.1186/s40695-021-00066-3
发表时间：
2021-08-28
期刊：
Women's midlife health
影响因子：
--
作者：
Diop MS;Taylor CN;Murillo SN;Zeidman JA;James AK;Burnett-Bowie SM
通讯作者：
Burnett-Bowie SM
影响因子：
5.6
作者：
Leonard, Stephanie A.;Main, Elliott K.;Carmichael, Suzan L.
通讯作者：
Carmichael, Suzan L.
影响因子：
1.5
作者：
Howell EA
通讯作者：
Howell EA
影响因子：
5.7
作者：
Beach, MC;Inui, T
通讯作者：
Inui, T