Spontaneous abortion-related deaths among women in the United States - 1981-1991
Spontaneous abortion-related deaths among women in the United States - 1981-1991
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DOI：
10.1016/s0029-7844(99)00280-x
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发表时间：
1999-08-01
影响因子：
7.2
通讯作者：
Atrash, HK
中科院分区：
文献类型：
--
作者：
Saraiya, M;Green, CA;Atrash, HK
目的：研究1981年至1991年自然流产相关死亡率的趋势和这些死亡的危险因素。方法：我们使用来自疾病控制和预防中心的妊娠死亡率监测系统的全国数据，以确定由于自然流产（小于20周妊娠）而死亡。病例死亡率定义为每100 000例自然流产中与自然流产有关的死亡人数。我们计算了每年的病死率，以及风险比的产妇年龄，种族，和gestational age.Results：在1981-1991年，共有62例自然流产相关的死亡报告的妊娠死亡率监测系统。总病死率为每10万例自然流产中有0.7例死亡。母亲年龄≥ 35岁（风险比[RR] 1.7，95%置信区间[CI] 0.9-3.0）、母亲种族非白色（RR 3.8，95% CI 2.2-5.9）和胎龄超过12周（RR 8.0，95% CI 4.2-11.9）是自然流产死亡的危险因素。在62例死亡中，59%由感染引起，18%由出血引起，13%由栓塞引起，5%由麻醉并发症引起，5%由其他原因引起。弥散性血管内凝血（DIC）是其中一半的死亡，它不是主要死因death.Conclusion：妇女35岁及以上，种族以外的其他白色，并在孕中期年龄的相关条件是在自然流产死亡的风险增加。此外，DIC使许多以死亡告终的自然流产病例复杂化。由于自然流产是怀孕的常见结果，因此建议继续监测自然流产相关死亡。
Objective: To examine trends in spontaneous abortion-related mortality and risk factors for these deaths from 1981 through 1991.Methods: We used national data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System to identify deaths due to spontaneous abortion (less than 20 weeks' gestation). Case-fatality rates were defined as the number of spontaneous abortion-related deaths per 100,000 spontaneous abortions. We calculated annual case-fatality rates as well as risk ratios by maternal age, race, and gestational age.Results: During 1981-1991, a total of 62 spontaneous abortion-related deaths were reported to the Pregnancy Mortality Surveillance System. The overall case fatality rate was 0.7 per 100,000 spontaneous abortions. Maternal age 35 years and older (risk ratio [RR] 1.7, 95% confidence interval [CI] 0.9-3.0), maternal race other than white (RR 3.8, 95% CI 2.2-5.9), and gestational age over 12 weeks (RR 8.0, 95% CI 4.2-11.9) were risk factors for death due to spontaneous abortion. Of the 62 deaths, 59% were caused by infection, 18% by hemorrhage, 13% by embolism, 5% from complications of anesthesia, and 5% by other causes. Disseminated intravascular coagulation (DIC) was an associated condition among half of those deaths for which it was not the primary cause of death.Conclusion: Women 35 years of age and older, of races other than white, and in the second trimester of pregnancy age are at increased risk of death from spontaneous abortion. In addition, DIC complicates many spontaneous abortion cases that end in death. Because spontaneous abortion is a common outcome of pregnancy, continued monitoring of spontaneous abortion-related deaths is recommended.