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[2007 - 2009年法国的孕产妇死亡率]

[Maternal mortality in France, 2007-2009].

作者信息

Saucedo M, Deneux-Tharaux C, Bouvier-Colle M-H

机构信息

Inserm U953, unité de recherche épidémiologique en santé périnatale et santé des femmes et des enfants, maternité de Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):613-27. doi: 10.1016/j.jgyn.2013.06.011. Epub 2013 Sep 13.

Abstract

To monitor the maternal mortality which is an indicator of the quality of obstetric and intensive care, France has a specific approach since 1996. Recently linkages have been introduced to improve the inclusion of cases. Here are the results for the 2007 to 2009 period. The identification of the pregnancy associated deaths is lying on different data bases that are medical causes of death, birth register and hospital discharges. To document the cases, confidential enquiries are conducted by two assessors on the field; a committee of medical experts analyses the documents, select the underlying cause and assess the quality of health care. Two hundred and fifty-four obstetric deaths were identified from 2007 to 2009 giving the maternal mortality ratio (MMR) of 10.3 per 100,000 births. The maternal age and nationality, the region of deaths are associated to the MMR. The haemorrhages are the leading cause but their ratio is 1.9 versus 2.5 previously; this decrease results from the postpartum haemorrhage by uterine atony going down. The suboptimal care are still frequent (60%) but slightly less than before. The linkage method should be pursued. Maternal mortality is rather stable in France. We may reach more reduction as deaths due to atony decreased as suboptimal care did.

摘要

为监测作为产科和重症监护质量指标的孕产妇死亡率,自1996年以来法国采用了一种特定方法。最近引入了关联措施以改善病例纳入情况。以下是2007年至2009年期间的结果。与妊娠相关死亡的识别基于不同数据库,即死因医学数据库、出生登记册和医院出院记录。为记录这些病例,两名评估员在实地进行保密调查;一个医学专家委员会分析文件,确定根本死因并评估医疗保健质量。2007年至2009年期间共识别出254例产科死亡病例,孕产妇死亡率(MMR)为每10万例分娩10.3例。孕产妇年龄、国籍、死亡地区与孕产妇死亡率相关。出血是主要死因,但其比例为1.9,而之前为2.5;这一下降是由于子宫收缩乏力导致的产后出血减少。护理欠佳情况仍然常见(60%),但略少于之前。应继续采用关联方法。法国的孕产妇死亡率相当稳定。随着因子宫收缩乏力导致的死亡减少以及护理欠佳情况减少,我们可能会实现更大幅度的降低。

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