加利福尼亚州分娩住院期间的孕产妇发病率。
Maternal morbidity during childbirth hospitalization in California.
作者信息
Lyndon Audrey, Lee Henry C, Gilbert William M, Gould Jeffrey B, Lee Kathryn A
机构信息
Department of Family Health Care Nursing, University of California, San Francisco, CA 94143, USA.
出版信息
J Matern Fetal Neonatal Med. 2012 Dec;25(12):2529-35. doi: 10.3109/14767058.2012.710280. Epub 2012 Aug 7.
OBJECTIVE
To determine the incidence and risk factors for maternal morbidity during childbirth hospitalization.
METHODS
Maternal morbidities were determined using ICD9-CM and vital records codes from linked hospital discharge and vital records data for 1,572,909 singleton births in California during 2005-2007. Socio-demographic, obstetric and hospital volume risk factors were estimated using mixed effects logistic regression models.
RESULTS
The maternal morbidity rate was 241/1000 births. The most common morbidities were episiotomy, pelvic trauma, maternal infection, postpartum hemorrhage and severe laceration. Preeclampsia (adjusted odds ratio [AOR]: 2.96; 95% confidence interval 2.8,3.13), maternal age over 35 years, (AOR: 1.92; 1.79,2.06), vaginal birth after cesarean, (AOR: 1.81; 1.47,2.23) and repeat cesarean birth (AOR: 1.99; 1.87,2.12) conferred the highest odds of severe morbidity. Non-white women were more likely to suffer morbidity.
CONCLUSIONS
Nearly one in four California women experienced complications during childbirth hospitalization. Significant health disparities in maternal childbirth outcomes persist in the USA.
目的
确定分娩住院期间孕产妇发病的发生率及危险因素。
方法
利用国际疾病分类第九版临床修正本（ICD9-CM）以及2005 - 2007年加利福尼亚州1,572,909例单胎分娩的医院出院记录与出生记录数据中的生命记录编码来确定孕产妇发病情况。采用混合效应逻辑回归模型评估社会人口统计学、产科及医院规模等危险因素。
结果
孕产妇发病率为241/1000例分娩。最常见的发病情况为会阴切开术、骨盆创伤、孕产妇感染、产后出血及严重撕裂伤。子痫前期（调整优势比[AOR]：2.96；95%置信区间2.8,3.13）、35岁以上孕产妇（AOR：1.92；1.79,2.06）、剖宫产术后阴道分娩（AOR：1.81；1.47,2.23）及再次剖宫产（AOR：1.99；1.87,2.12）发生严重发病的几率最高。非白人女性发病的可能性更高。
结论
加利福尼亚州近四分之一的女性在分娩住院期间出现并发症。美国孕产妇分娩结局方面存在显著的健康差异。
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