Streatfield P Kim, Alam Nurul, Compaoré Yacouba, Rossier Clementine, Soura Abdramane B, Bonfoh Bassirou, Jaeger Fabienne, Ngoran Eliezer K, Utzinger Juerg, Gomez Pierre, Jasseh Momodou, Ansah Akosua, Debpuur Cornelius, Oduro Abraham, Williams John, Addei Sheila, Gyapong Margaret, Kukula Vida A, Bauni Evasius, Mochamah George, Ndila Carolyne, Williams Thomas N, Desai Meghna, Moige Hellen, Odhiambo Frank O, Ogwang Sheila, Beguy Donatien, Ezeh Alex, Oti Samuel, Chihana Menard, Crampin Amelia, Price Alison, Delaunay Valérie, Diallo Aldiouma, Douillot Laetitia, Sokhna Cheikh, Collinson Mark A, Kahn Kathleen, Tollman Stephen M, Herbst Kobus, Mossong Joël, Emina Jacques B O, Sankoh Osman A, Byass Peter
Matlab HDSS, Bangladesh; International Centre for Diarrhoeal Disease Research, Bangladesh; INDEPTH Network, Accra, Ghana.
INDEPTH Network, Accra, Ghana; AMK HDSS, Bangladesh; Centre for Population, Urbanisation and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh.
Glob Health Action. 2014 Oct 29;7:25368. doi: 10.3402/gha.v7.25368. eCollection 2014.
Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps.
To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates.
Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death.
These analyses are based on reports from 14 INDEPTH sites, covering 14,198 deaths among WRA over 2,595,605 person-years observed. MMRs varied between 128 and 461 per 100,000 live births, while maternal mortality rates ranged from 0.11 to 0.74 per 1,000 person-years. Detailed rates per cause are tabulated, including analyses of direct maternal, indirect maternal, and incidental pregnancy-related deaths across the 14 sites.
As expected, these findings confirmed unacceptably high continuing levels of maternal mortality. However, they also demonstrate the effectiveness of INDEPTH sites and of the VA methods applied to arrive at measurements of maternal mortality that are essential for planning effective solutions and monitoring programmatic impacts.
在世界各地，仍有数量多得令人无法接受的妇女死于与妊娠相关的原因，尤其是在撒哈拉以南非洲和亚洲。部分问题在于缺乏准确的、基于人群的信息来描述这些问题并为解决方案提供依据。人口监测点，如在深入网络（INDEPTH Network）内运作的监测点，有潜力帮助弥合信息差距。
根据孕产妇死亡率（MMR）和特定原因死亡率，描述撒哈拉以南非洲和东南亚深入网络健康与人口监测系统监测点与妊娠相关的死亡模式。
使用深入网络2013年人口标准、世界卫生组织2012年死因推断（VA）标准以及用于确定死因的InterVA模型，将居住在深入网络监测点的育龄妇女（15 - 49岁）的个体死亡数据整理到一个标准化数据库中。
这些分析基于14个深入网络监测点的报告，涵盖了在2595605人年的观察期内14198例育龄妇女死亡。每10万例活产的孕产妇死亡率在128至461之间，而孕产妇死亡率为每1000人年0.11至0.74。列出了各原因的详细发生率，包括对14个监测点的直接孕产妇死亡、间接孕产妇死亡和与妊娠相关的偶发死亡的分析。
不出所料，这些发现证实了孕产妇死亡率持续处于令人无法接受的高水平。然而，它们也证明了深入网络监测点以及所应用的死因推断方法在得出孕产妇死亡率测量值方面的有效性，这些测量值对于规划有效的解决方案和监测项目影响至关重要。
