Bouvier-Colle M H, Varnoux N
Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 149, Recherches Epidémiologiques en santé périnatale et santé maternelle, 123, bd Port-Royal, 75014 Paris.
J Gynecol Obstet Biol Reprod (Paris). 2001 Oct;30(6 Suppl):S5-9.
Maternal mortality rates vary between different European countries. One hypothesis put forward to explain such differences is the potential discrepancy in the incidence of the main obstetrical complications. A European concerted action designed to estimate the incidence of severe post partum hemorrhage (> 1.5 l), PET, and sepsis was carried out in 1995-96 (MOMS-B survey) using standardized definitions and the same questionnaire in all regions. In the 13 regions in Europe involved in the study, including Champagne-Ardenne, Center and Lorraine in France, 1843 cases of obstetrical complication were identified among 182,589 births. The overall mean rate of severe maternal morbidity was 10.1 for 1000 births. This rate was 8.0 for Lorraine, 6.7 for Champagne-Ardenne and 5.5 for Center. The rates of hemorrhage and PET in the United Kingdom, Belgium and Finland were twice the rates in France and Norway. The inverse was observed for sepsis. Such discrepancies between countries, despite the use of standardized definitions, raises several questions. Was the methodology correctly applied? Were threatening situations correctly assessed in France? Was disease severity assessed in the same way in all countries? Further studies would be required to answer these questions.
欧洲不同国家的孕产妇死亡率各不相同。为解释这些差异而提出的一种假设是,主要产科并发症的发生率可能存在差异。1995 - 1996年开展了一项欧洲协同行动(MOMS - B调查),旨在估算严重产后出血(> 1.5升)、子痫前期及败血症的发生率,所有地区均采用标准化定义和相同问卷。在参与该研究的欧洲13个地区,包括法国的香槟 - 阿登大区、中央大区和洛林大区,在182,589例分娩中识别出1843例产科并发症。严重孕产妇发病的总体平均发生率为每1000例分娩10.1例。洛林地区为8.0例,香槟 - 阿登大区为6.7例,中央大区为5.5例。英国、比利时和芬兰的出血及子痫前期发生率是法国和挪威的两倍。败血症发生率则相反。尽管使用了标准化定义,但各国之间的这种差异引发了几个问题。方法是否正确应用?法国对危急情况的评估是否正确?所有国家对疾病严重程度的评估方式是否相同?需要进一步研究来回答这些问题。