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妊娠相关死亡的种族/民族差异 - 美国,2007-2016 年。

Racial/Ethnic Disparities in Pregnancy-Related Deaths - United States, 2007-2016.

出版信息

MMWR Morb Mortal Wkly Rep. 2019 Sep 6;68(35):762-765. doi: 10.15585/mmwr.mm6835a3.

Abstract

Approximately 700 women die in the United States each year as a result of pregnancy or its complications, and significant racial/ethnic disparities in pregnancy-related mortality exist (1). Data from CDC's Pregnancy Mortality Surveillance System (PMSS) for 2007-2016 were analyzed. Pregnancy-related mortality ratios (PRMRs) (i.e., pregnancy-related deaths per 100,000 live births) were analyzed by demographic characteristics and state PRMR tertiles (i.e., states with lowest, middle, and highest PRMR); cause-specific proportionate mortality by race/ethnicity also was calculated. Over the period analyzed, the U.S. overall PRMR was 16.7 pregnancy-related deaths per 100,000 births. Non-Hispanic black (black) and non-Hispanic American Indian/Alaska Native (AI/AN) women experienced higher PRMRs (40.8 and 29.7, respectively) than did all other racial/ethnic groups. This disparity persisted over time and across age groups. The PRMR for black and AI/AN women aged ≥30 years was approximately four to five times that for their white counterparts. PRMRs for black and AI/AN women with at least some college education were higher than those for all other racial/ethnic groups with less than a high school diploma. Among state PRMR tertiles, the PRMRs for black and AI/AN women were 2.8-3.3 and 1.7-3.3 times as high, respectively, as those for non-Hispanic white (white) women. Significant differences in cause-specific proportionate mortality were observed among racial/ethnic populations. Strategies to address racial/ethnic disparities in pregnancy-related deaths, including improving women's health and access to quality care in the preconception, pregnancy, and postpartum periods, can be implemented through coordination at the community, health facility, patient, provider, and system levels.

摘要

每年,美国约有 700 名妇女因怀孕或其并发症而死亡,而且妊娠相关死亡率存在显著的种族/族裔差异(1)。对 2007-2016 年疾病预防控制中心妊娠死亡率监测系统(PMSS)的数据进行了分析。按人口统计学特征和州妊娠相关死亡率三分位(即妊娠相关死亡率最低、中、最高的州)分析妊娠相关死亡率比(PRMR)(即每 10 万例活产中的妊娠相关死亡人数);还按种族/族裔计算了死因特异性比例死亡率。在所分析的期间内,美国总体 PRMR 为每 10 万例活产中 16.7 例妊娠相关死亡。非西班牙裔黑人(黑人)和非西班牙裔美洲印第安人/阿拉斯加原住民(AI/AN)妇女的 PRMR 较高(分别为 40.8 和 29.7),高于其他所有种族/族裔群体。这种差异随着时间的推移和年龄组而持续存在。年龄≥30 岁的黑人妇女和 AI/AN 妇女的 PRMR 大约是同龄白人妇女的四到五倍。受过至少一些大学教育的黑人妇女和 AI/AN 妇女的 PRMR 高于所有其他种族/族裔群体中未完成高中学业的妇女。在州妊娠相关死亡率三分位中,黑人妇女和 AI/AN 妇女的 PRMR 分别是非西班牙裔白人(白人)妇女的 2.8-3.3 倍和 1.7-3.3 倍。在不同种族/族裔人群中,死因特异性比例死亡率存在显著差异。通过在社区、卫生机构、患者、提供者和系统各级协调,可以实施解决妊娠相关死亡中的种族/族裔差异的策略,包括改善妇女在孕前、妊娠和产后期间的健康和获得优质护理。

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