Maternal morbidity during childbirth hospitalization in California.
Maternal morbidity during childbirth hospitalization in California.
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DOI：
10.3109/14767058.2012.710280
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Lee KA
中科院分区：
文献类型：
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作者：
Lyndon A;Lee HC;Gilbert WM;Gould JB;Lee KA
目的了解分娩住院期间孕产妇发病情况及危险因素。使用ICD9-CM和生命记录代码确定2005-2007年间加州1,572,909名单胎出生的产妇发病率。使用混合效应Logistic回归模型估计社会人口学、产科和医院容量危险因素。孕产妇发病率为241/1000。最常见的并发症是会阴切开、骨盆创伤、母体感染、产后出血和严重撕裂伤。先兆子痫(调整优势比[AOR]2.96；95%可信区间2.8，3.13)、母亲年龄>35岁(AOR 1.92；1.79，2.06)、剖宫产后阴道分娩(AOR 1.81；1.47，2.23)和再次剖宫产(AOR 1.99；1.87，2.12)具有较高的严重发病率。非白人女性更有可能患上疾病。近四分之一的加州妇女在分娩住院期间经历了并发症。在美国，产妇分娩结局方面的显著健康差距依然存在。
To determine the incidence and risk factors for maternal morbidity during childbirth hospitalization. Maternal morbidities were determined using ICD9-CM and vital records codes from linked hospital discharge and vital records data for 1,572,909 singleton births in California, 2005-2007. Sociodemographic, obstetric, and hospital volume risk factors were estimated using mixed effects logistic regression models. The maternal morbidity rate was 241/1000 births. The most common morbidities were episiotomy, pelvic trauma, maternal infection, postpartum hemorrhage, and severe laceration. Preeclampsia (Adjusted Odds Ratio [AOR] 2.96; 95% CI 2.8,3.13), maternal age over 35 years, (AOR 1.92; 1.79,2.06), vaginal birth after cesarean, (AOR 1.81; 1.47,2.23), and repeat cesarean birth (AOR 1.99; 1.87,2.12) conferred the highest odds of severe morbidity. Non-white women were more likely to suffer morbidity. Nearly one in four California women experienced complications during childbirth hospitalization. Significant health disparities in maternal childbirth outcomes persist in the United States.