Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia.
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia.
Lancet Glob Health. 2024 Feb;12(2):e317-e330. doi: 10.1016/S2214-109X(23)00454-0. Epub 2023 Dec 6.
Over the past three decades, substantial progress has been made in reducing maternal mortality worldwide. However, the historical focus on mortality reduction has been accompanied by comparative neglect of labour and birth complications that can emerge or persist months or years postnatally. This paper addresses these overlooked conditions, arguing that their absence from the global health agenda and national action plans has led to the misconception that they are uncommon or unimportant. The historical limitation of postnatal care services to the 6 weeks after birth is also a contributing factor. We reviewed epidemiological data on medium-term and long-term complications arising from labour and childbirth beyond 6 weeks, along with high-quality clinical guidelines for their prevention, identification, and treatment. We explore the complex interplay of human evolution, maternal physiology, and inherent predispositions that contribute to these complications. We offer actionable recommendations to change the current trajectories of these neglected conditions and help achieve the targets of Sustainable Development Goal 3. This paper is the third in a Series of four papers about maternal health in the perinatal period and beyond.
在过去的三十年中,全球范围内在降低产妇死亡率方面取得了重大进展。然而,历史上对死亡率的关注伴随着对产后数月或数年内可能出现或持续存在的劳动和分娩并发症的相对忽视。本文探讨了这些被忽视的情况,认为它们在全球卫生议程和国家行动计划中的缺失导致了人们对这些情况不常见或不重要的误解。产后护理服务仅在出生后 6 周内提供的历史局限性也是一个促成因素。我们回顾了关于产后 6 周以上劳动和分娩引起的中期和长期并发症的流行病学数据,以及这些并发症预防、识别和治疗的高质量临床指南。我们探讨了人类进化、产妇生理学和固有倾向之间的复杂相互作用,这些因素导致了这些并发症。我们提供了切实可行的建议,以改变这些被忽视的情况的当前轨迹,并帮助实现可持续发展目标 3 的目标。本文是关于围产期及以后产妇健康的系列四篇论文中的第三篇。