Maternal mortality, stillbirth and measures of obstetric care in developing and developed countries
Maternal mortality, stillbirth and measures of obstetric care in developing and developed countries
复制标题
DOI：
10.1016/j.ijgo.2006.10.010
复制
发表时间：
2007-02-01
影响因子：
3.8
通讯作者：
Bann, C. M.
中科院分区：
文献类型：
--
作者：
McClure, E. M.;Goldenberg, R. L.;Bann, C. M.
目的：孕产妇死亡和死产是重要的不良妊娠结局，特别是在发展中国家。由于这两种结果的根本原因似乎相似，孕产妇死亡率，死产和产科护理的三个措施之间的关系进行了研究。研究方法：利用世界卫生组织提供的来自188个发达国家和发展中国家的数据，对孕产妇死亡率和死胎率与剖腹产率、熟练助产护理和>= 4次产前检查之间的相关性和线性回归进行了分析。结果：死产率和孕产妇死亡率密切相关，每例孕产妇死亡约有5例死产。然而，这一比例从最不发达国家的2比1增至最发达国家的50比1。在发展中国家，随着剖腹产率从0上升到10%左右，孕产妇死亡率和死胎率都急剧下降。在达到约40%的覆盖率之前，熟练的接生护理与孕产妇死亡率或死产率的显著降低无关。在达到约60%的覆盖率之前，四次或四次以上的产前检查与孕产妇死亡率的显著降低无关。同样的措施只与死产的适度减少有关。结论：在各国，死产与孕产妇死亡率显著相关。死产和产妇死亡率同样与所有三项产科护理措施有关。剖宫产率从0增加到10%与孕产妇死亡率和死胎率的急剧下降有关。(c)2006年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: Maternal mortality and stillbirths are important adverse pregnancy outcomes, especially in developing countries. Because underlying causes of both outcomes appeared similar, the relationship between maternal mortality, stillbirth and three measures of obstetrical care were studied. Methods: Using data provided by the World Health Organization from 188 developed and developing countries, correlations and linear regression analyses between maternal mortality and stillbirth rates and cesarean section rates, skilled delivery attendance, and >= 4 prenatal visits) were developed. Results: Stillbirth and maternal mortality rates were strongly correlated, with about 5 stillbirths for each maternal death. However, the ratio increased from about 2 to 1 in least developed countries to 50 to 1 in the most developed countries. In developing countries, as the cesarean section rates increased from 0 to about 10%, both maternal mortality and stillbirth rates decreased sharply. Skilled delivery attendance was not associated with significant reductions in maternal mortality or stillbirth rates until coverage rates of about 40% were achieved. Four or more antenatal visits were not associated with significant reductions in maternal deaths until about 60% coverage was achieved. The same measure was associated with only modest decreases in stillbirth. Conclusion: Across countries, stillbirth was significantly associated with maternal mortality. Both stillbirth and maternal mortality were similarly related to all three measures of obstetric care. An increase in cesarean section rates from 0 to 10% was associated with sharp decreases in both maternal mortality and stillbirths. (c) 2006 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.