Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
Department of Gynecology and Obstetrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Taiwan J Obstet Gynecol. 2019 Sep;58(5):680-683. doi: 10.1016/j.tjog.2019.07.017.
To examine changes in the number and causes of maternal deaths after the introduction of pregnancy checkbox on the death certificate in January 2014 in Taiwan.
We first used the cause-of-death (COD) mortality data for years 2010 through 2017 to examine the number of deaths by item of pregnancy checkbox. We then compared the distribution of the causes of maternal deaths before and after the introduction of pregnancy checkbox.
Between 2014 and 2017, 111 women died, for whom the certifiers indicated the following in the pregnancy checkbox items: 2 (pregnant at the time of death; n = 10), 3 (died within 42 days after the termination of pregnancy; n = 64), and 4 (died between 43 days and 1 year after the termination of pregnancy; n = 37). However, in only 61 of the 111 deaths, the certifiers reported pregnancy or delivery-related diagnosis in the COD section of the death certificate-5 each for items 2 and 4 and 51 for item 3. The number of maternal deaths was 55 in 2010-2013; this number increased to 82 in 2014-2017. A decline in the percentage of maternal deaths from obstetric hemorrhage was noted from 38% (21/55) in 2010-2013 to 21% (17/82) in 2014-2017.
The number of maternal deaths increased, and the distribution of causes of maternal deaths changed after the introduction of pregnancy checkbox. Additional studies are required to examine the possible misclassification of pregnancy-associated deaths indicated in the pregnancy checkbox.
探讨 2014 年 1 月在台湾死亡证明上引入妊娠复选框后，孕产妇死亡数量和死因的变化。
我们首先使用 2010 年至 2017 年的死因死亡率数据，检查妊娠复选框各项目的死亡人数。然后，我们比较了引入妊娠复选框前后孕产妇死亡原因的分布情况。
2014 年至 2017 年间，有 111 名妇女死亡，其证明人在妊娠复选框项目中注明以下内容：2（死亡时怀孕；n=10）、3（妊娠终止后 42 天内死亡；n=64）和 4（妊娠终止后 43 天至 1 年内死亡；n=37）。然而，在这 111 例死亡中，只有 61 例证明人在死亡证明的死因部分报告了与妊娠或分娩相关的诊断——项目 2 和 4 各有 5 例，项目 3 有 51 例。2010-2013 年孕产妇死亡人数为 55 例；2014-2017 年这一数字增加到 82 例。从 2010-2013 年的 38%（21/55）到 2014-2017 年的 21%（17/82），产科出血导致的孕产妇死亡百分比有所下降。
引入妊娠复选框后，孕产妇死亡人数增加，孕产妇死亡原因分布发生变化。需要进一步研究以检查妊娠复选框中指出的与妊娠相关的死亡可能存在的错误分类。
