Maternal mortality in New York City: Excess mortality of black women
Maternal mortality in New York City: Excess mortality of black women
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DOI：
10.1007/bf02344034
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发表时间：
2000-12-01
影响因子：
6.6
通讯作者：
Alderman, MH
中科院分区：
文献类型：
--
作者：
Fang, J;Madhavan, S;Alderman, MH
为了评估纽约市的孕产妇死亡率，将纽约市1988年至1991年的出生证明和死亡率记录联系起来并进行了检查。在这7年中，纽约市每10万活产的孕产妇死亡率（根据《国际疾病分类》第9版[ICD-9]的定义，为630-676）大大超过了全国的水平（分别为20.2比8.2）。在纽约市，按种族/族裔划分的产妇死亡率差异更大，白人、黑人和西班牙裔的死亡率分别为每10万活产7.1、39.5和14.4。受教育程度、婚姻状况和收入等社会经济特征对非黑人孕产妇死亡率的影响大于黑人。死因特异性死亡率分析显示，总体而言，异位妊娠、栓塞和高血压是主要的死亡原因。然而，黑人产妇死亡率偏高的主要原因是高血压（黑人与白人死亡率之比为5.57,95%可信区间为2.30 ~ 13.39）、异位妊娠（4.78,95%可信区间为2.40 ~ 9.51）和流产（4.58,95%可信区间为1.72 ~ 12.22）。这些发现证实了黑人和白人妇女在产妇死亡率方面的持续差距。事实上，如果所有怀孕的纽约人都能享受到该市非西班牙裔白人居民的生存，那么纽约市和全国孕产妇死亡率的差异将被消除。
To assess maternal mortality in New York City, birth certificates and mortality records for New York City from 1988 through 1991 were linked and examined. During these 7 years, maternal mortality in New York City (defined by the International Classification of Diseases, 9th edition [ICD-9], as 630-676) per 100,000 live births significantly exceeded that of the country as a whole (20.2 vs. 8.2, respectively). Within New York City, an even greater variation of maternal mortality by race/ethnicity was noted, with the mortality ratio of whites, blacks, and Hispanics being 7.1, 39.5, and 14.4 per 100,000 live births, respectively. Socioeconomic characteristics such as educational attainment, marital status, and income influenced maternal mortality more in non-blacks than blacks. Analyses of cause-specific mortality revealed that, overall, ectopic pregnancy, embolism, and hyper-tension were the leading causes of death. However, the major factors explaining the excess maternal mortality among blacks were hypertension (mortality ratio of blacks to whites 5.57, 95% confidence interval 2.30-13.39), ectopic pregnancy (4.78, 95% confidence interval 2.40-9.51), and abortion (4.58, 95% confidence interval 1.72-12.22). These findings confirm a persisting gap in maternal death between black and white women. Indeed, if all New Yorkers who became pregnant enjoyed the survival of the city's non-Hispanic white residents, the difference in maternal mortality between the city and the nation would be eliminated.