Neal Sarah, Mahendra Shanti, Bose Krishna, Camacho Alma Virginia, Mathai Matthews, Nove Andrea, Santana Felipe, Matthews Zoë
Department of Social Statistics and Demography, University of Southampton, Southampton, UK.
Options Consultancy Services, London, UK.
BMC Pregnancy Childbirth. 2016 Nov 11;16(1):352. doi: 10.1186/s12884-016-1120-8.
While the main causes of maternal mortality in low and middle income countries are well understood, less is known about whether patterns for causes of maternal deaths among adolescents are the same as for older women. This study systematically reviews the literature on cause of maternal death in adolescence. Where possible we compare the main causes for adolescents with those for older women to ascertain differences and similarity in mortality patterns.
An initial search for papers and grey literature in English, Spanish and Portuguese was carried out using a number of electronic databases based on a pre-determined search strategy. The outcome of interest was the proportion of maternal deaths amongst adolescents by cause of death. A total of 15 papers met the inclusion criteria established in the study protocol.
The main causes of maternal mortality in adolescents are similar to those of older women: hypertensive disorders, haemorrhage, abortion and sepsis. However some studies indicated country or regional differences in the relative magnitudes of specific causes of adolescent maternal mortality. When compared with causes of death for older women, hypertensive disorders were found to be a more important cause of mortality for adolescents in a number of studies in a range of settings. In terms of indirect causes of death, there are indications that malaria is a particularly important cause of adolescent maternal mortality in some countries.
The main causes of maternal mortality in adolescents are broadly similar to those for older women, although the findings suggest some heterogeneity between countries and regions. However there is evidence that the relative importance of specific causes may differ for this younger age group compared to women over the age of 20 years. In particular hypertensive conditions make up a larger share of maternal deaths in adolescents than older women. Further, large scale studies are needed to investigate this question further.
虽然低收入和中等收入国家孕产妇死亡的主要原因已为人熟知，但青少年孕产妇死亡原因模式是否与年龄较大的妇女相同却鲜为人知。本研究系统回顾了有关青少年孕产妇死亡原因的文献。在可能的情况下，我们将青少年的主要死亡原因与年龄较大妇女的进行比较，以确定死亡模式的差异和相似之处。
根据预先确定的检索策略，使用多个电子数据库对英文、西班牙文和葡萄牙文的论文及灰色文献进行了初步检索。感兴趣的结果是按死亡原因划分的青少年孕产妇死亡比例。共有15篇论文符合研究方案中设定的纳入标准。
青少年孕产妇死亡的主要原因与年龄较大的妇女相似：高血压疾病、出血、流产和败血症。然而，一些研究表明，青少年孕产妇死亡的特定原因在相对严重程度上存在国家或地区差异。与年龄较大妇女的死亡原因相比，在一系列环境中的多项研究发现，高血压疾病是青少年死亡的一个更重要原因。就间接死亡原因而言，有迹象表明疟疾在一些国家是青少年孕产妇死亡的一个特别重要原因。
青少年孕产妇死亡的主要原因与年龄较大的妇女大致相似，尽管研究结果表明国家和地区之间存在一些异质性。然而，有证据表明，与20岁以上的妇女相比，这个较年轻年龄组特定原因的相对重要性可能有所不同。特别是，高血压疾病在青少年孕产妇死亡中所占比例高于年龄较大的妇女。此外，需要进行大规模研究以进一步调查这个问题。
