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死产:经济和心理社会后果。

Stillbirths: economic and psychosocial consequences.

机构信息

Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK; St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; International Stillbirth Alliance, New York, NY, USA.

International Stillbirth Alliance, New York, NY, USA; Academic Centre for Women's Health, University of Bristol, Bristol, UK; Southmead Hospital, Bristol, UK.

出版信息

Lancet. 2016 Feb 6;387(10018):604-616. doi: 10.1016/S0140-6736(15)00836-3. Epub 2016 Jan 19.

Abstract

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.

摘要

尽管死胎的发生频率很高,但随后的影响却被忽视和低估了。我们通过全面、系统的文献回顾,以及对已发表和未发表数据的新分析,来确定死胎对全球父母、家庭、医疗保健提供者和社会的影响。关于这一事件直接成本的数据很少,但有研究表明,死胎比活产需要更多的资源,无论是在围产期,还是在后续妊娠期间的额外监测中。死胎的间接和无形成本广泛存在,而且通常由家庭独自承担。对于资源较少的家庭来说,这个问题尤其沉重。护理人员的同理心态度和有针对性的干预措施可能会减轻死胎对父母心理健康的负面影响。应该考虑婴儿的价值,以及父母、家庭、护理提供者、社区和社会的相关成本,以预防死胎并减少相关发病率。

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