Fong A, Leake J, Pan D, Ogunyemi D
Department of Obstetrics and Gynaecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
J Obstet Gynaecol. 2010;30(5):470-5. doi: 10.3109/01443615.2010.487576.
This study, initially presented at the SMFM Annual Conference in San Diego on 29 January 2009, sought to explore the risk factors for mortality from postpartum haemorrhage (PPH). A total of 138,316 cases of PPH from 1991 to 2000 were identified using the California Health Discharge Database. Data analysed included demographic information and clinical risk factors. PPH increased from 1.9% to 2.8%, while mortality rate decreased during the study period (1991-2000). Logistic regression showed that hysterectomy, hypertensive disorders, abruption, transverse caesarean delivery, and classical caesarean delivery, increased risk for PPH mortality, while manual placental extraction, episiotomy, and laceration repairs decreased risk. Two geographical regions, Inland Empire and Orange County, were associated with increased PPH mortality, despite having lower incidence of PPH. Teaching status and investor ownership of hospitals increased the risk of PPH mortality. There was no associated change in mortality based on hospital quality rating.
本研究最初于2009年1月29日在圣地亚哥举行的SMFM年会上发表，旨在探讨产后出血（PPH）导致死亡的风险因素。利用加利福尼亚州健康出院数据库，确定了1991年至2000年间总共138316例产后出血病例。分析的数据包括人口统计学信息和临床风险因素。在研究期间（1991 - 2000年），产后出血发生率从1.9%上升至2.8%，而死亡率下降。逻辑回归显示，子宫切除术、高血压疾病、胎盘早剥、横位剖宫产和古典式剖宫产会增加产后出血死亡风险，而人工剥离胎盘、会阴切开术和裂伤修复则会降低风险。尽管内陆帝国和奥兰治县这两个地理区域的产后出血发生率较低，但它们与产后出血死亡率增加有关。医院的教学状况和投资者所有权增加了产后出血死亡风险。基于医院质量评级，死亡率没有相关变化。
