Geller Stacie E, Koch Abigail R, Martin Nancy J, Rosenberg Deborah, Bigger Harold R
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, IL; Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL.
Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL.
Am J Obstet Gynecol. 2014 Dec;211(6):698.e1-11. doi: 10.1016/j.ajog.2014.06.046. Epub 2014 Jun 20.
We sought to describe the potential preventability of pregnancy-related deaths in Illinois from 2002 through 2012 as determined by perinatal centers following the Illinois maternal death review process.
We conducted a retrospective review of all known maternal deaths in the state from 2002 through 2012 with complete records in the Illinois Department of Public Health's Maternal Mortality Review Form database. The association between causes of death and potential preventability was analyzed for pregnancy-related deaths.
There were 610 maternal deaths in Illinois during the study period (31.8 per 100,000 live births). One-third of maternal deaths (n = 210) were directly or indirectly related to pregnancy, 7.0% (n = 43) were possibly related, and 52.6% (n = 321) were unrelated. Vascular causes were the most common cause of pregnancy-related death, followed by cardiac causes and hemorrhage. One-third of deaths directly or indirectly related to pregnancy were deemed potentially preventable. Hemorrhage and deaths due to psychiatric causes were most likely to be considered avoidable, while cancer and vascular-related deaths were generally not considered preventable.
This analysis of pregnancy-related deaths in Illinois, the first in >60 years, found similar causes of death and potential preventability as pregnancy-related death reviews in other states. Analyzing the causes of pregnancy-related death is a critical and necessary step in improving maternal health outcomes, particularly in decreasing potentially preventable pregnancy-related deaths. Greater attention should be directed toward intervening on the provider, systems, and patient factors contributing to preventable deaths.
我们试图描述2002年至2012年伊利诺伊州与妊娠相关死亡的潜在可预防性，这是由围产期中心根据伊利诺伊州孕产妇死亡审查程序确定的。
我们对2002年至2012年该州所有已知的孕产妇死亡病例进行了回顾性研究，这些病例在伊利诺伊州公共卫生部的孕产妇死亡率审查表格数据库中有完整记录。分析了与妊娠相关死亡的死因与潜在可预防性之间的关联。
研究期间伊利诺伊州有610例孕产妇死亡（每10万例活产中有31.8例）。三分之一的孕产妇死亡（n = 210）与妊娠直接或间接相关，7.0%（n = 43）可能相关，52.6%（n = 321）不相关。血管性病因是与妊娠相关死亡的最常见原因，其次是心脏性病因和出血。与妊娠直接或间接相关的死亡中有三分之一被认为具有潜在可预防性。出血和精神疾病导致的死亡最有可能被认为是可避免的，而癌症和血管相关死亡通常不被认为是可预防的。
这项对伊利诺伊州与妊娠相关死亡的分析是60多年来的首次，发现其死亡原因和潜在可预防性与其他州的妊娠相关死亡审查相似。分析与妊娠相关死亡的原因是改善孕产妇健康结局的关键且必要步骤，特别是在减少潜在可预防的与妊娠相关死亡方面。应更加关注对导致可预防死亡的医疗服务提供者、系统和患者因素进行干预。
