Department of Gynecology, Obstetrics and Neonatology, University of Bari, Via Celentano 42, 70121 Bari, Italy.
Arch Gynecol Obstet. 2012 Jun;285(6):1499-503. doi: 10.1007/s00404-012-2301-y. Epub 2012 Mar 28.
To review the literature about MD in developed countries.
A search in PubMed, EMBASE, Medline and reference lists was performed. Key words: maternal death/mortality, pregnancy death and obstetric/maternity care. Articles were selected if they reported the cause of death per livebirths, were performed in developed countries and unselected population, classified MD by the World Health Organization. Maternal age, cause of MD, time of MD (antepartum, intrapartum, postpartum) and delivery mode were abstracted. MD was expressed as maternal mortality ratio (MMR). PRISMA guidelines were followed.
Twelve articles provided data from 1980 to 2007. The MD rate was 9,750 in 75,560,683 livebirths (MMR: 12.90). MD was direct in 6,791 women (MMR: 8.98), being postpartum hemorrhage the leading cause, and indirect in 2,786 women (MMR: 3.68), with cardiovascular disease as the main cause. The remaining 173 deaths (MMR: 0.22) were unexplained. Maternal age >45 years, vaginal delivery, postpartum period increased the risk of MD. MD reduced over time in all countries except in the Netherlands and USA.
Conditions leading to hemorrhage warrant strict management. The risk of an apparently healthy woman to die during motherhood is 0.22 out of 100,000 livebirths.
综述发达国家的孕产妇死亡情况。
在 PubMed、EMBASE、Medline 和参考文献中进行检索。关键词：孕产妇死亡/死亡率、妊娠死亡和产科/孕产妇保健。如果文章报告了每例活产的死因、在发达国家和未选择人群中进行、按照世界卫生组织分类孕产妇死亡，则选择这些文章。提取孕产妇年龄、孕产妇死亡原因、孕产妇死亡时间（产前、产时、产后）和分娩方式。孕产妇死亡率表示为孕产妇死亡率（MMR）。遵循 PRISMA 指南。
12 篇文章提供了 1980 年至 2007 年的数据。75560683 例活产中有 9750 例孕产妇死亡（MMR：12.90）。直接死因导致 6791 名妇女死亡（MMR：8.98），其中产后出血是主要原因，间接死因导致 2786 名妇女死亡（MMR：3.68），主要原因为心血管疾病。其余 173 例死亡（MMR：0.22）原因不明。产妇年龄>45 岁、阴道分娩、产后期增加了孕产妇死亡的风险。除荷兰和美国外，所有国家的孕产妇死亡率均呈下降趋势。
导致出血的情况需要严格管理。每 10 万例活产中，健康妇女死于分娩的风险为 0.22。
