Schuurmans Jorien, Borgundvaag Emily, Finaldi Pasquale, Senat-Delva Rodnie, Desauguste Fedner, Badjo Colette, Lekkerkerker Michiel, Grandpierre Reynaldo, Lerebours Gerald, Ariti Cono, Lenglet Annick
Médecins Sans Frontières Port-au-Prince Haiti Médecins Sans Frontières, Port-au-Prince, Haiti.
Médecins Sans Frontières Amsterdam Netherlands Médecins Sans Frontières, Amsterdam, The Netherlands.
Rev Panam Salud Publica. 2021 Nov 1;45:e147. doi: 10.26633/RPSP.2021.147. eCollection 2021.
To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-)eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales, an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse pregnancy outcomes.
We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services.
A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204 (0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%) low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55-6.55) and low birthweight (OR 1.40; 95% CI 1.05-1.86) for women with complicated pregnancies.
To prevent and treat pregnancy complications as early as possible, antenatal care attendance is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant women in Haiti is recommended.
确定海地太子港一家产科急诊医院——产科急诊参考中心中患（先兆）子痫及妊娠或分娩复杂的女性的孕产妇死亡、死产和低出生体重的发生率，并确定这些不良妊娠结局的主要风险因素。
我们利用医院记录，对2013年至2018年间入住产科急诊参考中心的孕妇进行了一项回顾性队列研究。调查的风险因素包括年龄组、妊娠类型（单胎、多胎）、分娩类型和产前护理服务的使用情况。
分析共纳入31509名女性和24983次分娩。其中，确定有204例（0.6%）孕产妇死亡（每10万名分娩女性中有648例）、1962例（7.9%）死产和11008例（44.1%）低出生体重新生儿。在所有入院患者中，10991例（34.9%）为患（先兆）子痫的女性。剖宫产显著增加了妊娠复杂女性和患（先兆）子痫女性的孕产妇死亡风险，但降低了此类女性的死产风险。对于妊娠复杂的女性，未接受产前护理与显著更高的死产风险（比值比（OR）4.82；95%置信区间（CI）3.55 - 6.55）和低出生体重风险（OR 1.40；95%CI 1.05 - 1.86）相关。
为尽早预防和治疗妊娠并发症，产前护理至关重要。建议提高海地产前护理服务的质量和可及性，并为所有孕妇免费提供该服务。
