Santé publique France, non-communicable diseases and trauma division, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France.
Inserm U1153, Perinatal and paediatric obstetrical epidemiology research team (EPOPé), Centre for epidemiology and statistics (CRESS), Paris Descartes University, Risks and Pregnancy DHU, Maternité Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France.
Anaesth Crit Care Pain Med. 2019 Aug;38(4):363-369. doi: 10.1016/j.accpm.2018.12.007. Epub 2018 Dec 21.
Maternal intensive care unit admission is an indicator of severe maternal morbidity. The objective of this study was to estimate rates of maternal intensive care unit admission during or following pregnancy in France, and to describe the characteristics of women concerned, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014.
Women hospitalised in France in intensive care units during pregnancy or up to 42 days after pregnancy between January 2010 and December 2014 were identified using the national hospital discharge database (PMSI-MCO). Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model.
In total, 16,011 women were admitted to intensive care units, representing an overall incidence of 3.97‰ deliveries. This number decreased significantly by 1.7% on average per year. For women who gave birth (60.5% by C-section), 62.5% of admissions occurred during their hospitalisation for delivery. The SAPS II score, an indicator of severity, significantly increased from 18.4 in 2010 to 21.5 in 2014. Obstetrical haemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. In mainland France, the Ile-de-France (i.e., greater Paris) region had the highest rates of intensive care units admission (5.05‰) while the Pays-de-la-Loire region had the lowest (2.69‰).
The rate of maternal intensive care unit admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. In-depth studies are needed to understand the territorial disparities identified.
产妇重症监护病房入院是严重产妇发病率的一个指标。本研究的目的是估计法国在怀孕期间或怀孕后 42 天内产妇重症监护病房入院率，并描述相关妇女的特征、病情严重程度、相关诊断、区域差异以及 2010 年至 2014 年期间的时间趋势。
使用国家住院数据库（PMSI-MCO）确定 2010 年 1 月至 2014 年 12 月期间在法国重症监护病房住院的孕妇或怀孕后 42 天内的孕妇。使用泊松回归模型，基于平均年变化百分比量化发病率的变化趋势。
共有 16011 名妇女入住重症监护病房，总发病率为 3.97‰分娩。这一数字平均每年下降 1.7%。对于分娩的妇女（60.5%行剖宫产），62.5%的入院发生在分娩住院期间。严重性指标 SAPS II 评分从 2010 年的 18.4 分显著增加到 2014 年的 21.5 分。产科出血（39.8%）和妊娠高血压并发症（24.8%）是最常见的入院原因。在法国本土，法兰西岛（即大巴黎地区）的重症监护病房入院率最高（5.05‰），而卢瓦尔河地区最低（2.69‰）。
法国产妇重症监护病房入院率从 2010 年到 2014 年下降，同时病情严重程度增加。需要深入研究以了解确定的地域差异。
