母国的人类发展指数及其与产妇严重不良事件的关系：文献系统综述。
Human Development Index of the maternal country of origin and its relationship with maternal near miss: A systematic review of the literature.
机构信息
Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, HGUGM, Calle O' Donnell, 48, Planta 0, 28009, Madrid, Spain.
Department of Public and Maternal-Infant Health, Complutense University, Madrid, Spain.
出版信息
BMC Pregnancy Childbirth. 2020 Apr 16;20(1):224. doi: 10.1186/s12884-020-02901-3.
BACKGROUND
The reduction in maternal mortality worldwide has increased the interest in studying more frequent severe events such as maternal near miss. The Human Development Index is a sociodemographic country-specific variable that includes key human development indicators such as living a long and healthy life, acquiring knowledge, and enjoying a decent standard of living, allowing differentiation between countries. In a globalised environment, it is necessary to study whether the Human Development Index of each patient's country of origin can be associated with the maternal near-miss rate and thus classify the risk of maternal morbidity and mortality.
METHODS
A systematic review of the literature published between 2008 and 2019 was conducted, including all articles that reported data about maternal near miss in their sample of pregnant women, in addition to describing the study countries of their sample population. The Human Development Index of the study country, the maternal near-miss rate, the maternal mortality rate, and other maternal-perinatal variables related to morbidity and mortality were used.
RESULTS
After the systematic review, eighty two articles from over thirty countries were included, for a total of 3,699,697 live births, 37,191 near miss cases, and 4029 mortality cases. A statistically significant (p <0.05) inversely proportional relationship was observed between the Human Development Index of the study country and the maternal near-miss and mortality rates. The most common cause of maternal near miss was haemorrhage, with an overall rate of 38.5%, followed by hypertensive disorders of pregnancy (34.2%), sepsis (7.5%), and other undefined causes (20.9%).
CONCLUSIONS
The Human Development Index of the maternal country of origin is a sociodemographic variable allowing differentiation and classification of the risk of maternal mortality and near miss in pregnant women. The most common cause of maternal near miss published in the literature was haemorrhage.
TRIAL REGISTRATION
PROSPERO ID: CRD 42019133464.
背景
全球范围内孕产妇死亡率的降低增加了对更频繁发生的严重事件（如孕产妇危急重症接近发生）的研究兴趣。人类发展指数是一个社会人口学的国家特定变量，其中包括一些关键的人类发展指标，如长寿健康、获取知识和享受体面的生活水平，从而可以对各国进行区分。在全球化的环境下，有必要研究每个患者原籍国的人类发展指数是否可以与孕产妇危急重症接近发生的发生率相关，从而对孕产妇发病率和死亡率的风险进行分类。
方法
对 2008 年至 2019 年间发表的文献进行了系统回顾，纳入了所有报告其孕妇样本中孕产妇危急重症接近发生数据的文章，同时还描述了其样本人群的研究国家。使用了研究国家的人类发展指数、孕产妇危急重症接近发生发生率、孕产妇死亡率和其他与发病率和死亡率相关的孕产妇围产期变量。
结果
经过系统回顾，从三十多个国家共纳入了 82 篇文章，总计有 3699697 例活产、37191 例危急重症接近发生和 4029 例死亡。研究国家的人类发展指数与孕产妇危急重症接近发生发生率和死亡率呈显著负相关（p<0.05）。孕产妇危急重症接近发生最常见的原因是出血，总体发生率为 38.5%，其次是妊娠高血压疾病（34.2%）、败血症（7.5%）和其他未明确原因（20.9%）。
结论
孕产妇原籍国的人类发展指数是一个社会人口学变量，可以对孕妇的孕产妇死亡率和危急重症接近发生风险进行区分和分类。文献中报道的孕产妇危急重症接近发生最常见的原因是出血。
注册
PROSPERO 注册号：CRD 42019133464。
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