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预测拉丁美洲国家监测点网络中的严重产妇结局。

Predicting severe maternal outcomes in a network of sentinel sites in Latin-American countries.

机构信息

Department of Preventive and Social Medicine, School of Medicine, Udelar, Uruguay.

Clinical and Research Unit (UNICEM), Montevideo, Uruguay.

出版信息

Int J Gynaecol Obstet. 2023 Mar;160(3):939-946. doi: 10.1002/ijgo.14436. Epub 2022 Sep 24.

Abstract

OBJECTIVE

This study aimed to determine incidences of potentially life-threatening conditions (PLTC), maternal near misses (MNM), and maternal deaths (MD) in women who gave birth in participating facilities, and to determine the probability that a pregnancy involving a PLTC would evolve into an MNM and/or an MD.

METHODS

This was a multicentric observational study implemented on a maternal network from August 2018 to May 2019 in five Latin-American countries. We summarized categorical variables as frequencies and continuous variables with median, interquartile range, and standard deviations. Positive and negative likelihood ratios were calculated and multivariate predictive models were built.

RESULTS

There were 33 901 deliveries and miscarriages, of which 8.0% had at least one PLTC and 0.6% had an MNM. Hypertensive disorder was the most frequent condition to evolve into a severe maternal outcome.

CONCLUSION

Identifying PLTC can help to prevent MNM and MD. The inclusion of these predictors in a real-time data registration system like the Perinatal Informatic System could work as a surveillance tool for early detection, leading to a reduction in the rate of worsening conditions.

摘要

目的

本研究旨在确定参与研究的医疗机构中分娩女性的潜在危及生命情况(PLTC)、孕产妇接近死亡病例(MNM)和孕产妇死亡(MD)发生率,并确定涉及 PLTC 的妊娠发展为 MNM 和/或 MD 的概率。

方法

这是一项多中心观察性研究,于 2018 年 8 月至 2019 年 5 月在五个拉丁美洲国家的一个孕产妇网络中实施。我们将分类变量总结为频率,将连续变量总结为中位数、四分位距和标准差。计算阳性和阴性似然比,并建立多变量预测模型。

结果

共发生 33901 例分娩和流产,其中 8.0%至少有一种 PLTC,0.6%发生 MNM。高血压疾病是最常见的发展为严重孕产妇结局的情况。

结论

识别 PLTC 有助于预防 MNM 和 MD。将这些预测因素纳入围产期信息系统等实时数据登记系统可作为早期检测的监测工具,从而降低病情恶化的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2984/10087448/65d25f819dfb/IJGO-160-939-g001.jpg

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