Stillbirths: recall to action in high-income countries
Stillbirths: recall to action in high-income countries
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DOI：
10.1016/s0140-6736(15)01020-x
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发表时间：
2016-02-13
期刊：
影响因子：
168.9
通讯作者：
Goldenberg, Robert L.
中科院分区：
文献类型：
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作者：
Flenady, Vicki;Wojcieszek, Aleena M.;Goldenberg, Robert L.
高收入国家之间死产率的差异和高收入国家内部巨大的公平差距仍然存在。如果所有高收入国家的死产率都达到表现最好的国家的水平，那么在2015年就可以避免19439例妊娠晚期（28周或更长时间）死产。原因不明的死产比例很高，可以通过改进数据收集、调查和分类以及更好地了解因果途径来解决。不合格的护理导致了所有死产的20-30%，而在妊娠晚期的产时死产中，这一比例甚至更高。需要在所有高收入国家实施国家围产期死亡率审计规划。减少与死产有关的耻辱和宿命论以及改善丧亲护理的需要也是明确的、持续的行动重点。在高收入国家，生活在不利社会经济环境下的妇女生死胎的风险是条件较好的妇女的两倍。社区和国家一级的方案需要改善处境不利家庭的健康，以解决这些不平等现象。
Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation ( 28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.