Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2010 Jun;15(6):733-42. doi: 10.1111/j.1365-3156.2010.02534.x. Epub 2010 Apr 8.
To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences.
Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months.
The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9-17.0)], fever [adjusted OR = 1.71 (1.1-2.8)] and infant mortality [adjusted OR = 11.0 (0.8-158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3-9.0)], urine leakages [adjusted OR = 2.7 (1.2-5.8)], and to report poor health [adjusted OR = 5.27 (2.2-12.4)] and pregnancy's negative effects on their life [adjusted OR = 4.11 (1.9-9.0)]. Uptake of post-natal services was poor in all groups.
Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group.
记录严重产科并发症对贝宁产妇产后健康和 12 个月以上婴儿死亡率的影响，并评估与围产儿死亡相关的严重并发症是否特别可能导致不良健康后果。
本队列研究对经历严重并发症或无并发症分娩的妇女及其婴儿进行了随访。在医院选择妇女，并在出院时、产后 6 个月和 12 个月在家中进行访谈。妇女在产后 6 个月和 12 个月时被邀请进行体检。
该队列包括 205 名患有严重并发症并活产的妇女、64 名患有严重并发症和围产儿死亡的妇女以及 440 名无并发症分娩的妇女。与正常分娩的妇女相比，患有严重并发症并活产的妇女在产后健康方面没有明显差异，除了高血压[调整后的 OR=5.8（1.9-17.0）]、发热[调整后的 OR=1.71（1.1-2.8）]和婴儿死亡率[调整后的 OR=11.0（0.8-158.2）]。有并发症和围产儿死亡的妇女患抑郁症的风险增加[调整后的 OR=3.4（1.3-9.0）]、尿漏[调整后的 OR=2.7（1.2-5.8）]，并报告健康状况不佳[调整后的 OR=5.27（2.2-12.4）]和妊娠对其生活的负面影响[调整后的 OR=4.11（1.9-9.0）]。所有组的产后服务利用率都很低。
发展中国家的妇女在妊娠和分娩期间面临严重并发症的高风险。这些并发症可能对她们自己和她们子女的健康造成不良后果。需要资源确保孕妇在出院前、期间和之后得到足够的护理。围产儿死亡的接近病例妇女似乎是一个特别高风险的群体。
