The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates
The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates
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DOI：
10.2105/ajph.2005.072975
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发表时间：
2007-02-01
影响因子：
12.7
通讯作者：
Hsia, Jason
中科院分区：
文献类型：
--
作者：
Tucker, Myra J.;Berg, Cynthia J.;Hsia, Jason
目标。我们试图确定5种特定妊娠并发症的患病率差异或这些并发症的病死率差异是否解释了美国黑人妇女与白人妇女相比妊娠相关死亡率不成比例的风险。我们使用国家数据集来计算1988年至1999年间黑人和白人妇女先兆子痫、子痫、胎盘早剥、前置胎盘和产后出血的患病率和病死率。黑人妇女的患病率并没有明显高于白人妇女。然而，患有这些疾病的黑人妇女死于这些疾病的可能性是白人妇女的2到3倍。黑人妇女因先兆子痫、子痫、胎盘早剥、前置胎盘和产后出血导致的妊娠相关死亡率较高，这在很大程度上可归因于较高的病死率。通过更精确地确定影响并发症严重程度和死亡风险的机制，包括生物学和卫生服务的复杂相互作用，然后将这些知识应用于设计改善妊娠相关结果的干预措施，可以降低病死率。
Objectives. We sought to determine whether differences in the prevalences of 5 specific pregnancy complications or differences in case fatality rates for those complications explained the disproportionate risk of pregnancy-related mortality for Black women compared with White women in the United States.Methods. We used national data sets to calculate prevalence and case-fatality rates among Black and White women for preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage for the years 1988 to 1999.Results. Black women did not have significantly greater prevalence rates than White women. However, Black women with these conditions were 2 to 3 times more likely to die from them than were White women.Conclusions. Higher pregnancy-related mortality among Black women from preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage is largely attributable to higher case-fatality rates. Reductions in case-fatality rates may be made by defining more precisely the mechanisms that affect complication severity and risk of death, including complex interactions of biology and health services, and then applying this knowledge in designing interventions that improve pregnancy-related outcomes.