Wang Siwen, Rexrode Kathryn M, Florio Andrea A, Rich-Edwards Janet W, Chavarro Jorge E
Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; email:
Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Annu Rev Med. 2023 Jan 27;74:199-216. doi: 10.1146/annurev-med-042921-123851.
Maternal mortality is unusually high in the United States compared to other wealthy nations and is characterized by major disparities in race/ethnicity, geography, and socioeconomic factors. Similar to other developed nations, the United States has seen a shift in the underlying causes of pregnancy-related death, with a relative increase in mortality resulting from diseases of the cardiovascular system and preexisting medical conditions. Improved continuity of care aimed at identifying reproductive-age women with preexisting conditions that may heighten the risk of maternal death, preconception management of risk factors for major adverse pregnancy outcomes, and primary care visits within the first year after delivery may offer opportunities to address gaps in medical care contributing to the unacceptable rates of maternal mortality in the United States.
与其他富裕国家相比,美国的孕产妇死亡率异常高,且在种族/族裔、地理位置和社会经济因素方面存在重大差异。与其他发达国家类似,美国与妊娠相关死亡的潜在原因也发生了转变,心血管系统疾病和既往存在的医疗状况导致的死亡率相对增加。旨在识别可能增加孕产妇死亡风险的患有既往疾病的育龄妇女、对重大不良妊娠结局的风险因素进行孕前管理以及在分娩后第一年内进行初级保健就诊,改善医疗服务的连续性,可能为解决导致美国孕产妇死亡率高得令人无法接受的医疗服务差距提供机会。