Filippi Véronique, Ganaba Rasmané, Baggaley Rebecca F, Marshall Tom, Storeng Katerini T, Sombié Issiaka, Ouattara Fatoumata, Ouedraogo Thomas, Akoum Mélanie, Meda Nicolas
London School of Hygiene and Tropical Medicine, London, UK.
Lancet. 2007 Oct 13;370(9595):1329-37. doi: 10.1016/S0140-6736(07)61574-8.
Little is known about the health of women who survive obstetric complications in poor countries. Our aim was to determine how severe obstetric complications in Burkina Faso affect a range of health, social, and economic indicators in the first year post partum.
We did a prospective cohort study of women with severe obstetric complications recruited in hospitals when their pregnancy ended with a livebirth (n=199), perinatal death (74), or a lost pregnancy (64). For every woman with severe obstetric complications, two unmatched control women with uncomplicated delivery were sampled in the same hospital (677). All women were followed up for 1 year.
Women with severe obstetric complications were poorer and less educated at baseline than were women with uncomplicated delivery. Women with severe obstetric complications, and their babies, were significantly more likely to die after discharge: six (2%) of the 337 women with severe obstetric complications died within 1 year, compared with none of the women with uncomplicated delivery (unadjusted p=0.001); 17 babies of women with severe obstetric complications died within 1 year, compared with 18 of those born by uncomplicated delivery (hazard ratio for mortality 4.67, 95% CI 1.68-13.04, adjusted for loss to follow-up and confounders; p=0.003). Women with severe obstetric complications were significantly more likely to have experienced depression and anxiety at 3 months (odds ratio 1.82, 95% CI 1.18-2.80), to have experienced suicidal thoughts within the past year at all time points (2.27, 1.33-3.89 at 3 months; 2.30, 1.17-4.50 at 6 months; 2.26, 1.30-3.95 at 12 months), and to report the pregnancy having had a negative effect on their lives at all time points (1.54, 1.04-2.30 at 3 months; 2.30, 1.56-3.39 at 6 months; 2.44, 1.63-3.65 at 12 months) than were women with uncomplicated delivery.
Women who give birth with severe obstetric complications are at greater risk of death and mental-health problems than are women with uncomplicated delivery. Greater resources are needed to ensure that these women receive adequate care before and after discharge from hospital.
在贫困国家，关于患有产科并发症后存活下来的女性的健康状况，人们知之甚少。我们的目的是确定布基纳法索的严重产科并发症如何影响产后第一年一系列健康、社会和经济指标。
我们对患有严重产科并发症的女性进行了一项前瞻性队列研究，这些女性在医院分娩时，妊娠结局为活产（n = 199）、围产期死亡（74例）或妊娠丢失（64例）。对于每一位患有严重产科并发症的女性，在同一家医院抽取两名未匹配的顺产对照女性（677例）。所有女性均随访1年。
患有严重产科并发症的女性在基线时比顺产女性更贫穷且受教育程度更低。患有严重产科并发症的女性及其婴儿出院后死亡的可能性显著更高：337例患有严重产科并发症的女性中有6例（2%）在1年内死亡，而顺产女性无一例死亡（未调整p = 0.001）；患有严重产科并发症的女性中有17例婴儿在1年内死亡，而顺产出生的婴儿中有18例死亡（调整随访失访和混杂因素后，死亡风险比为4.67，95%CI 1.68 - 13.04；p = 0.003）。与顺产女性相比，患有严重产科并发症的女性在3个月时出现抑郁和焦虑的可能性显著更高（优势比1.82，95%CI 1.18 - 2.80），在过去一年的所有时间点都有自杀念头（3个月时为2.27，1.33 - 3.89；6个月时为2.30，1.17 - 4.50；12个月时为2.26，1.30 - 3.95），并且在所有时间点都报告此次妊娠对其生活产生了负面影响（3个月时为1.54，1.04 - 2.30；6个月时为2.30，1.56 - 3.39；12个月时为2.44，1.63 - 3.65）。
与顺产女性相比，患有严重产科并发症分娩的女性死亡和心理健康问题的风险更高。需要更多资源来确保这些女性在出院前后得到充分护理。
Zotero 插件