Pre- eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health
Pre- eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health
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DOI：
10.1111/1471-0528.12629
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发表时间：
2014-03-01
影响因子：
5.8
通讯作者：
Souza, J. P.
中科院分区：
文献类型：
--
作者：
Abalos, E.;Cuesta, C.;Souza, J. P.
目的评估妊娠期高血压疾病及相关严重并发症的发生率，确定其他相关因素，并比较患有和不患有这些疾病的妇女的孕产妇和围产期结局。设计对世界卫生组织孕产妇和新生儿健康多国调查（WHOMCS）数据库进行二次分析。设置在非洲、亚洲、拉丁美洲和中东 29 个国家每年进行 1000 次或以上分娩的 357 个卫生机构进行横断面研究。人口所有患有任何妊娠期高血压疾病的妇女研究期间参与医院的妊娠期、产时或产后早期的高血压疾病。方法我们根据高血压疾病的严重程度计算了研究人群中预先指定的结果的比例及其分布。我们使用多级 Logit 模型估计了它们与孕产妇死亡、未遂病例和严重孕产妇并发症之间的关联。主要结局指标妊娠期高血压疾病。孕产妇未遂事故、孕产妇死亡和无严重孕产妇结局的病例中存在潜在危及生命的情况。结果总体而言，8542 名 (2.73%) 妇女患有高血压疾病。先兆子痫、子痫和慢性高血压的发生率分别为2.16%、0.28%和0.29%。与没有先兆子痫的妇女相比，患有先兆子痫的妇女中孕产妇险情的发生率要高出 8 倍，而患有子痫的妇女则要高出 60 倍。 结论 对这个大型数据库的分析提供了妊娠期高血压疾病发病率全球分布的估计。有关先兆子痫和子痫相关最常见并发症的信息可能有助于为卫生系统组织制定政策。
ObjectiveTo assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions.DesignSecondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database.SettingCross-sectional study implemented at 357 health facilities conducting 1000 or more deliveries annually in 29 countries from Africa, Asia, Latin America and the Middle East.PopulationAll women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period.MethodsWe calculated the proportion of the pre-specified outcomes in the study population and their distribution according to hypertensive disorders' severity. We estimated the association between them and maternal deaths, near-miss cases, and severe maternal complications using a multilevel logit model.Main outcome measuresHypertensive disorders of pregnancy. Potentially life-threatening conditions among maternal near-miss cases, maternal deaths and cases without severe maternal outcomes.ResultsOverall, 8542 (2.73%) women suffered from hypertensive disorders. Incidences of pre-eclampsia, eclampsia and chronic hypertension were 2.16%, 0.28% and 0.29%, respectively. Maternal near-miss cases were eight times more frequent in women with pre-eclampsia, and increased to up to 60 times more frequent in women with eclampsia, when compared with women without these conditions.ConclusionsThe analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre-eclampsia and eclampsia could be of interest to inform policies for health systems organisation.