Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.
Obstet Gynecol. 2012 Aug;120(2 Pt 1):261-8. doi: 10.1097/AOG.0b013e31825cb87a.
To compare trends in and causes of pregnancy-related mortality by race, ethnicity, and nativity from 1993 to 2006.
We used data from the Pregnancy Mortality Surveillance System. For each race, ethnicity, and nativity group, we calculated pregnancy-related mortality ratios and assessed causes of pregnancy-related death and the time between the end of pregnancy and death.
Race, ethnicity, and nativity-related minority women contributed 40.7% of all U.S. live births but 61.8% of the 7,487 pregnancy-related deaths during 1993-2006. Pregnancy-related mortality ratios were 9.1 and 7.5 deaths per 100,000 live births among U.S.- and foreign-born white women, respectively, and slightly higher at 9.6 and 11.6 deaths per 100,000 live births for U.S.- and foreign-born Hispanic women, respectively. Relative to U.S.-born white women, age-standardized pregnancy-related mortality ratios were 5.2 and 3.6 times higher among U.S.- and foreign-born black women, respectively. However, causes and timing of death within 42 days postpartum were similar for U.S.-born white and black women with cardiovascular disease, cardiomyopathy, and other pre-existing medical conditions emerging as chief contributors to mortality. Hypertensive disorders, hemorrhage, and embolism were the most important causes of pregnancy-related death for all other groups of women.
Except for foreign-born white women, all other race, ethnicity, and nativity groups were at higher risk of dying from pregnancy-related causes than U.S.-born white women after adjusting for age differences. Integration of quality-of-care aspects into hospital- and state-based maternal death reviews may help identify race, ethnicity, and nativity-specific factors for pregnancy-related mortality.
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比较 1993 年至 2006 年间按种族、民族和出生地划分的妊娠相关死亡率的趋势和原因。
我们使用了妊娠死亡率监测系统的数据。对于每个种族、民族和出生地群体，我们计算了妊娠相关死亡率比，并评估了妊娠相关死亡的原因以及妊娠结束和死亡之间的时间。
种族、民族和出生地相关的少数族裔妇女仅占美国活产婴儿的 40.7%，但在 1993 年至 2006 年期间，占所有妊娠相关死亡人数的 61.8%。美国和外国出生的白人妇女的妊娠相关死亡率分别为每 10 万活产婴儿 9.1 和 7.5 例死亡，而美国和外国出生的西班牙裔妇女的妊娠相关死亡率分别略高，为每 10 万活产婴儿 9.6 和 11.6 例死亡。与美国出生的白人妇女相比，美国和外国出生的黑人妇女的年龄标准化妊娠相关死亡率分别高 5.2 和 3.6 倍。然而，在美国出生的白人和黑人妇女中，产后 42 天内死亡的原因和时间相似，心血管疾病、心肌病和其他先前存在的医疗条件是导致死亡的主要原因。高血压疾病、出血和栓塞是所有其他妇女群体妊娠相关死亡的最重要原因。
除了外国出生的白人妇女外，所有其他种族、民族和出生地群体在调整年龄差异后，因妊娠相关原因死亡的风险都高于美国出生的白人妇女。将医疗质量方面的内容纳入医院和州一级的孕产妇死亡审查中，可能有助于确定妊娠相关死亡率的种族、民族和出生地特定因素。
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