Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
Clinics (Sao Paulo). 2013 Jul;68(7):922-7. doi: 10.6061/clinics/2013(07)06.
To study the prevalence of potentially life-threatening maternal conditions and near miss in Brazil according to maternal age.
A secondary analysis of the 2006 Brazilian demographic health survey database using a validated questionnaire to evaluate maternal morbidity with a focus on age extremes. The study included 5,025 women with at least 1 live birth in the 5-year reference period preceding their interviews. Three age range periods were used: 15-19 years (younger age), 20-34 years (control), and 35-49 years (advanced maternal age). According to a pragmatic definition, any woman reporting eclampsia, hysterectomy, blood transfusion, or admission to the intensive care unit during her pregnancy/childbirth was considered a near-miss case. The associations between age and severe maternal morbidity were further assessed.
For the 6,833 reported pregnancies, 73.7% of the women were 20-34 years old, 17.9% were of advanced maternal age, and only 8.4% were of younger age. More than 22% of the women had at least one of the complications appraised, and blood transfusion, which was more prevalent among the controls, was the only variable with a significant difference among the age groups. The overall rate of maternal near miss was 21.1 per 1000 live births. There was a trend of higher maternal near miss with increasing age. The only significant risk factor identified for maternal near miss was a lower literacy level among older women.
There is a trend towards worse results with increasing age. The investigation of the determinants of maternal near miss at the community level using an innovative approach through a demographic health survey is an example suggested for under-resourced settings.
根据产妇年龄，研究巴西潜在危及生命的产妇疾病和接近发生的病例的流行情况。
使用经过验证的问卷，对 2006 年巴西人口健康调查数据库进行二次分析，评估产妇发病率，并特别关注年龄极值。该研究纳入了在接受访谈前 5 年参考期内至少有 1 次活产的 5025 名妇女。研究使用了 3 个年龄范围：15-19 岁（年轻组）、20-34 岁（对照组）和 35-49 岁（高龄产妇组）。根据实用定义，任何报告子痫、子宫切除术、输血或在怀孕期间/分娩期间入住重症监护病房的妇女均被视为接近发生病例。进一步评估了年龄与严重产妇发病率之间的关系。
在报告的 6833 次妊娠中，73.7%的妇女年龄在 20-34 岁之间，17.9%为高龄产妇，仅有 8.4%为年轻产妇。超过 22%的妇女至少有一种评估的并发症，而对照组中更为常见的输血是年龄组之间唯一具有显著差异的变量。总的产妇接近发生的比例为每 1000 例活产 21.1 例。随着年龄的增长，产妇接近发生的比例呈上升趋势。确定的唯一产妇接近发生的显著危险因素是高龄产妇的文化程度较低。
随着年龄的增长，结果呈恶化趋势。通过人口健康调查以创新方法在社区层面调查产妇接近发生病例的决定因素是资源匮乏环境的一个建议示例。
