Bond Rachel M, Gaither Kecia, Nasser Samar A, Albert Michelle A, Ferdinand Keith C, Njoroge Joyce N, Parapid Biljana, Hayes Sharonne N, Pegus Cheryl, Sogade Bola, Grodzinsky Anna, Watson Karol E, McCullough Cassandra A, Ofili Elizabeth
Women's Heart Health, Dignity Health, AZ (R.M.B.).
Internal Medicine, Creighton University School of Medicine, Chandler, AZ (R.M.B.).
Circ Cardiovasc Qual Outcomes. 2021 Feb;14(2):e007643. doi: 10.1161/CIRCOUTCOMES.120.007643. Epub 2021 Feb 10.
Following decades of decline, maternal mortality began to rise in the United States around 1990-a significant departure from the world's other affluent countries. By 2018, the same could be seen with the maternal mortality rate in the United States at 17.4 maternal deaths per 100 000 live births. When factoring in race/ethnicity, this number was more than double among non-Hispanic Black women who experienced 37.1 maternal deaths per 100 000 live births. More than half of these deaths and near deaths were from preventable causes, with cardiovascular disease being the leading one. In an effort to amplify the magnitude of this epidemic in the United States that disproportionately plagues Black women, on June 13, 2020, the Association of Black Cardiologists hosted the Black Maternal Heart Health Roundtable-a collaborative task force to tackle the maternal health crisis in the Black community. The roundtable brought together diverse stakeholders and champions of maternal health equity to discuss how innovative ideas, solutions and opportunities could be implemented, while exploring additional ways attendees could address maternal health concerns within the health care system. The discussions were intended to lead the charge in reducing maternal morbidity and mortality through advocacy, education, research, and collaborative efforts. The goal of this roundtable was to identify current barriers at the community, patient, and clinician level and expand on the efforts required to coordinate an effective approach to reducing these statistics in the highest risk populations. Collectively, preventable maternal mortality can result from or reflect violations of a variety of human rights-the right to life, the right to freedom from discrimination, and the right to the highest attainable standard of health. This is the first comprehensive statement on this important topic. This position paper will generate further research in disparities of care and promote the interest of others to pursue strategies to mitigate maternal mortality.
经过数十年的下降后,美国的孕产妇死亡率在1990年左右开始上升,这与世界上其他富裕国家形成了显著差异。到2018年,美国的孕产妇死亡率为每10万例活产中有17.4例孕产妇死亡。考虑到种族/族裔因素,非西班牙裔黑人女性的这一数字翻了一番多,达到每10万例活产中有37.1例孕产妇死亡。这些死亡和濒死事件中,超过一半是由可预防的原因导致的,其中心血管疾病是主要原因。为了凸显这场在美国 disproportionately 困扰黑人女性的流行病的严重程度,2020年6月13日,黑人心脏病学家协会主办了黑人孕产妇心脏健康圆桌会议——一个旨在解决黑人社区孕产妇健康危机的协作特别工作组。该圆桌会议汇聚了孕产妇健康公平的不同利益相关者和倡导者,讨论如何实施创新理念、解决方案和机会,同时探索与会者在医疗保健系统内解决孕产妇健康问题的其他途径。这些讨论旨在通过宣传、教育、研究和协作努力,带头降低孕产妇发病率和死亡率。本次圆桌会议的目标是确定社区、患者和临床医生层面当前的障碍,并进一步阐述为协调采取有效方法降低高危人群的这些统计数据所需开展的工作。总体而言,可预防的孕产妇死亡可能源于或反映了对各种人权的侵犯——生命权、不受歧视权以及享有能达到的最高健康标准的权利。这是关于这一重要主题的首份全面声明。本立场文件将推动对护理差距的进一步研究,并促进其他人对寻求降低孕产妇死亡率策略的兴趣。