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加强产后过渡期的护理,以解决母婴健康方面的种族差异问题。

Strengthening the postpartum transition of care to address racial disparities in maternal health.

机构信息

Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

出版信息

J Natl Med Assoc. 2019 Aug;111(4):349-351. doi: 10.1016/j.jnma.2018.10.016. Epub 2018 Nov 30.

Abstract

Maternal morbidity and mortality, important indicators of healthcare quality both nationally and internationally, have gained increasing public attention in the United States (U.S.). The U.S. has the highest rate of maternal mortality among high-income countries; notably, this rate has more than doubled since 1990. Black women in the U.S. die at three to four times the rate of white women from pregnancy-related complications, one of the widest of all racial disparities in women's health. Medical complications, including cardiovascular disease and hypertensive disorders in pregnancy, remain leading contributors to disparities in maternal outcomes including pregnancy-related deaths. However, an under-explored opportunity for improvement is the failure to transition from obstetrical to primary care, which limits optimizing postpartum health. Health system approaches, community-based interventions, and policy solutions that facilitate transitions of care may be critical to eliminating persistent disparities in maternal outcomes.

摘要

孕产妇发病率和死亡率是衡量一个国家医疗质量的重要指标,无论是在国内还是国际上,都受到了越来越多的关注。美国是高收入国家中孕产妇死亡率最高的国家;值得注意的是,自 1990 年以来,这一比率已经翻了一番多。美国黑人妇女死于与怀孕相关的并发症的几率是白人妇女的三到四倍,这是所有种族在妇女健康方面差距最大的之一。医疗并发症,包括心血管疾病和妊娠高血压疾病,仍然是导致孕产妇结局差异(包括与怀孕相关的死亡)的主要原因。然而,一个改善的机会尚未得到充分探索,即未能从产科过渡到初级保健,这限制了优化产后健康。促进护理过渡的卫生系统方法、基于社区的干预措施和政策解决方案,对于消除孕产妇结局方面持续存在的差异可能至关重要。

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