Rochat R W, Koonin L M, Atrash H K, Jewett J F
Centers for Disease Control, Atlanta, Georgia.
Obstet Gynecol. 1988 Jul;72(1):91-7.
To better define the incidence, causes, and risk factors associated with maternal deaths, the Maternal Mortality Collaborative in 1983 initiated national voluntary surveillance of maternal mortality. The Maternal Mortality Collaborative reported 601 maternal deaths from 19 reporting areas for 1980-1985, representing a maternal mortality ratio of 14.1 per 100,000 live births. Overall, 37% more maternal deaths were reported by the Maternal Mortality Collaborative than by the National Center for Health Statistics for these reporting areas. Older women and women of black and other races continued to have higher mortality than younger women and white women. The five most common causes of death for all reported cases were embolism, nonobstetric injuries, hypertensive disease of pregnancy, ectopic pregnancy, and obstetric hemorrhage. Compared with national maternal mortality for 1974-1978, ratios were lower for all causes except for indirect causes, anesthesia, and cerebrovascular accidents. Fatal injuries among pregnant women are not commonly reported to maternal mortality committees. As maternal mortality from direct obstetric causes continues to decline, clinicians will need to emphasize preventing deaths from nonobstetric causes.
为了更准确地界定孕产妇死亡的发生率、原因及相关风险因素，孕产妇死亡率协作组织于1983年启动了全国孕产妇死亡自愿监测项目。孕产妇死亡率协作组织报告了1980 - 1985年来自19个报告地区的601例孕产妇死亡病例，孕产妇死亡率为每10万例活产中有14.1例死亡。总体而言，孕产妇死亡率协作组织报告的这些报告地区的孕产妇死亡病例比国家卫生统计中心多37%。老年女性以及黑人及其他种族的女性死亡率持续高于年轻女性和白人女性。所有报告病例中最常见的五个死亡原因是栓塞、非产科损伤、妊娠期高血压疾病、宫外孕和产科出血。与1974 - 1978年全国孕产妇死亡率相比，除间接原因、麻醉和脑血管意外外，所有原因导致的死亡率均有所下降。孕妇的致命伤通常不会上报给孕产妇死亡委员会。随着直接产科原因导致的孕产妇死亡率持续下降，临床医生需要着重预防非产科原因导致的死亡。
