Fisk N M, Atun R
Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
BJOG. 2009 Feb;116(3):347-56. doi: 10.1111/j.1471-0528.2008.02027.x.
Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas.
To assess absolute and relative government and charitable funding for maternal and perinatal research in the UK and internationally. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Major research funding bodies and alliances were identified from an Internet search and discussions with opinion leaders/senior investigators. Websites and annual reports were reviewed for details of strategy, research spend, grants awarded, and allocation to maternal and/or perinatal disease using generic and disease-specific search terms.
Within the imprecision in the data sets, < or =1% of health research spend in the UK was on maternal/perinatal health. Other countries fared better with 1-4% investment, although nonexclusive categorisation may render this an overestimate. In low-resource settings, government funders focused on infectious disease but not maternal and perinatal health despite high relative disease burden, while global philanthropy concentrated on service provision rather than research. Although research expenditure has been deemed as appropriate for 'reproductive health' disease burden in the UK, there are no data on the equity of maternal/perinatal research spend against disease burden, which globally may justify a manyfold increase.
AUTHOR'S CONCLUSIONS: This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment.
与其他疾病领域相比，孕期研究资金不足这一广泛存在的观点几乎没有公开证据支持。
评估英国及国际上政府和慈善机构对孕产妇和围产期研究的绝对和相对资金投入。检索策略、选择标准、数据收集与分析：通过互联网搜索以及与意见领袖/资深研究者的讨论，确定了主要的研究资助机构和联盟。使用通用和特定疾病的检索词，对各机构网站和年度报告进行审查，以获取战略细节、研究支出、授予的资助以及对孕产妇和/或围产期疾病的资金分配情况。
在数据集存在不精确性的情况下，英国卫生研究支出中用于孕产妇/围产期健康的比例≤1%。其他国家情况较好，投资比例为1 - 4%，不过非排他性分类可能导致这一比例被高估。在资源匮乏地区，政府资助者专注于传染病研究，而非孕产妇和围产期健康研究，尽管后者疾病负担相对较高，而全球慈善事业则集中于服务提供而非研究。尽管英国的研究支出被认为与“生殖健康”疾病负担相适应，但没有关于孕产妇/围产期研究支出与疾病负担公平性的数据，从全球来看，这可能需要增加许多倍的投入。
对国家和国际资助机构的研究支出及优先事项进行的这项系统评价表明，孕产妇/围产期健康研究的投资相对不足。促成因素包括对妇女健康的政治重视程度低、孕期临床研究的挑战性以及长期投资不足导致的研究能力匮乏。
