尼日利亚卡拉巴尔大学教学医院 1999-2009 年孕产妇死亡率趋势。
Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999-2009.
机构信息
Department of Obstetrics and Gynecology, College of MedicalSciences, University of Calabar Teaching Hospital, Nigeria.
出版信息
Int J Womens Health. 2010 Aug 10;2:249-54. doi: 10.2147/ijwh.s11971.
BACKGROUND
Maternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.
OBJECTIVE
The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.
METHODOLOGY
This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009). All pregnancy-related deaths of patients managed at the hospital were included in the study.
RESULTS
A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3%) of the deaths were in women aged 20-34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%), followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%). About 69.26% of these women had no antenatal care. The majority (61.04%) died within the first 48 hours of admission.
CONCLUSION
Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially Type III delay. Efforts must be put in place by government, hospital management, and society to reduce these figures further. Above all, there must be an attitudinal change towards obstetric emergencies by health care providers.
背景
孕产妇死亡仍然是一个主要的公共卫生挑战，不仅在卡拉巴尔大学教学医院，而且在发展中国家也是如此。
目的
本研究旨在评估一家三级保健机构的孕产妇死亡率趋势、孕产妇死亡率比、社会人口因素对死亡的影响以及医院孕产妇死亡的常见医疗和社会原因。
方法
这是对 11 年来（1999 年 1 月 1 日至 2009 年 12 月 31 日）产科服务记录的回顾性分析。所有在医院管理的与妊娠相关的患者死亡均包括在研究中。
结果
在审查期间，共记录了 15264 例活产和 231 例孕产妇死亡，孕产妇死亡率为每 100000 例活产 1513.4 例。在过去两年中，孕产妇死亡人数呈下降趋势，较 1999 年下降了约 69.0%。大多数（63.3%）死亡发生在 20-34 岁的妇女中，33.33%至少完成了小学教育，约 55.41%失业。8 人具有高等教育学历。三分之二的妇女已婚。产科出血是导致死亡的主要原因（32.23%），其次是妊娠高血压疾病。III 型延迟占死亡的 48.48%，其次是 I 型延迟（35.5%）。约 69.26%的妇女没有产前护理。大多数（61.04%）妇女在入院后 48 小时内死亡。
结论
尽管在研究期间孕产妇死亡率呈下降趋势，但减少的幅度被认为不足。本研究确定的孕产妇死亡的医疗和社会原因是可以预防的，尤其是 III 型延迟。政府、医院管理层和社会必须做出努力，进一步降低这些数字。最重要的是，医疗保健提供者必须对产科急症的态度发生转变。
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