Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality
Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality
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DOI：
10.1186/s12884-015-0789-4
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发表时间：
2016-03-02
影响因子：
3.1
通讯作者：
Say, Lale
中科院分区：
文献类型：
--
作者：
Chou, Doris;Tuncalp, Oezge;Say, Lale
背景：产妇发病率是一个复杂的实体，其表现和严重程度是一个频谱。本文描述了孕产妇发病率定义的概念化和发展，以及其测量框架：孕产妇发病率矩阵，这是测量孕产妇发病率的基础，因此，评估工具。讨论：我们将孕产妇发病和相关残疾定义为“任何归因于和/或使妊娠和分娩复杂化并对妇女的健康和/或功能产生负面影响的健康状况”。通过专家会议、对《国际疾病和相关健康问题分类》（ICD-10）的审查、文献审查、适用产妇发病率的定义和以0.1%的患病率为截止值，得出了121种情况的矩阵。该矩阵有三个维度：确定的发病率类别，报告的功能影响和产妇历史。发病的鉴别标准包括58种症状、29种体征、44项调查和35项管理策略；这些标准的目的是确认医疗状况或功能影响/残疾组成部分，以反映妇女所遭受的负面影响。摘要：产妇发病率矩阵是评估产妇发病率的实用框架。鉴于全民健康覆盖（UHC）作为2015年后可持续发展目标（sdg）规划的一部分日益受到关注，定义和标准识别标准对于衡量其范围和影响至关重要。
Background: Maternal morbidity is a complex entity and its presentation and severity are on a spectrum. This paper describes the conceptualization and development of a definition for maternal morbidity, and the framework for its measurement: the maternal morbidity matrix, which is the foundation for measuring maternal morbidity, thus, the assessment tool.Discussion: We define maternal morbidity and associated disability as "any health condition attributed to and/or complicating pregnancy and childbirth that has a negative impact on the woman's wellbeing and/or functioning." A matrix of 121 conditions was generated through expert meetings, review of the International Classification of Diseases and related health problems (ICD-10), literature reviews, applying the definition of maternal morbidity and a cut-off of >0.1 % prevalence. This matrix has three dimensions: identified morbidity category, reported functioning impact and maternal history. The identification criteria for morbidity include 58 symptoms, 29 signs, 44 investigations and 35 management strategies; these criteria are aimed at recognizing the medical condition, or the functional impact/disability component that will capture the negative impact experienced by the woman.Summary: The maternal morbidity matrix is a practical framework for assessing maternal morbidity beyond near-miss. In light of the emerging attention to Universal Health Coverage (UHC) as part of the post-2015 Sustainable Development Goals (SDGs) planning, a definition and standard identification criteria are essential to measuring its extent and impact.