University of Hawaii, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI 96826, USA.
J Perinatol. 2012 Mar;32(3):163-9. doi: 10.1038/jp.2011.74. Epub 2011 Jun 9.
The objective of this study was to demonstrate the increasing importance of heart disease as a cause of pregnancy-related mortality in Hawaii and the rest of the United States.
Hawaii's Department of Public Health identified all pregnancy-associated death certificates from 1991 to 2007. Hospital records and autopsy reports were reviewed to determine whether deaths were pregnancy-related.
From 1991 to 2007, Hawaii registered 156 deaths occurring within 1 year of pregnancy, which represented 4.2% of the total number of women who died in the same 17 to 46 years age group and 9.0% of the total number of women who died in the same 17 to 34 years age group. The pregnancy-related mortality ratio was 22.4 and the pregnancy-associated mortality ratio was 50. The leading cause of pregnancy-associated mortality was heart disease (20.5%) followed by cancer (18.6%) and suicide/homicide (12.2%). Pregnancy-related deaths (n=70) were attributed to heart disease (45.7%) followed by sepsis (14.2%) and hemorrhage (12.9%). The new Hawaii death certificate beginning in 2006 increased the detection of both pregnancy-related and -associated deaths.
Heart disease is the most common cause of pregnancy-related mortality in Hawaii, and with improved ascertainment, may be determined to be the most common cause of pregnancy-related mortality in the rest of the United States.
本研究旨在展示心脏病作为夏威夷乃至美国其他地区妊娠相关死亡原因的重要性日益增加。
夏威夷公共卫生部确定了 1991 年至 2007 年所有与妊娠相关的死亡证明。审查了医院记录和尸检报告，以确定死亡是否与妊娠有关。
1991 年至 2007 年，夏威夷登记了 156 例在妊娠后 1 年内发生的死亡，占同期 17 至 46 岁年龄组总死亡人数的 4.2%，占同期 17 至 34 岁年龄组总死亡人数的 9.0%。妊娠相关死亡率为 22.4，妊娠相关死亡率为 50。导致妊娠相关死亡的主要原因是心脏病（20.5%），其次是癌症（18.6%）和自杀/他杀（12.2%）。与妊娠相关的死亡（n=70）归因于心脏病（45.7%），其次是败血症（14.2%）和出血（12.9%）。2006 年开始的新的夏威夷死亡证明增加了对妊娠相关和相关死亡的检测。
心脏病是夏威夷妊娠相关死亡的最常见原因，随着检测方法的改进，可能被确定为美国其他地区妊娠相关死亡的最常见原因。
