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中高收入国家地区层面的贫困作为死产的一个风险因素:一项范围综述

Area-level deprivation as a risk factor for stillbirth in upper-middle and high-income countries: A scoping review.

作者信息

Keane Jessica V, Robinson Laura A, Greene Richard A, Corcoran Paul, Leitao Sara

机构信息

National Perinatal Epidemiology Centre, University College Cork, Ireland.

College of Medicine and Health, University College Cork, Ireland.

出版信息

Midwifery. 2025 Feb;141:104251. doi: 10.1016/j.midw.2024.104251. Epub 2024 Dec 1.

Abstract

BACKGROUND

Socioeconomic deprivation has been associated with health inequalities and poor perinatal outcomes. Deprivation is described as a multidimensional concept, with composite indicators (e.g. area-based) developed internationally to study population health.

AIM

This scoping review aims to examine published literature on the relationship between area-level deprivation and stillbirth in upper-middle to high-income countries.

METHODS

The Joanna Briggs Institute methodology for scoping reviews was utilised. The research question based on the Population (studies that examined stillbirth) Concept (area-level deprivation and its impact on stillbirth) Context (upper-middle- to high-income countries) framework. Six scientific databases were searched. Results were screened and reference lists searched to identify relevant literature. Data extraction on study characteristics and evidence of association provided was completed and a narrative summary reported the main findings.

RESULTS

A total of 29 studies were included, from 9 countries (majority UK-based: n = 20) published between 1998 and 2023. A variety of composite deprivation indices were utilised, the UK's Index of Multiple Deprivation (IMD) was the most common (n = 8), followed by the Townsend and Jarman indices (n = 6 and n = 3, respectively). Income, employment, education and access to services were the most common factors included as measures of deprivation in the indices. Twenty-two of the 29 studies (75.9%) showed positive correlations between stillbirth and areas identified more socioeconomically deprived.

CONCLUSION

This review suggests that area-level deprivation seems an influencing factor on stillbirth in upper-middle to high-income countries. Focused initiatives to reduce stillbirth among those at higher deprivation related risk may be useful in improving maternal and perinatal outcomes.

摘要

背景

社会经济剥夺与健康不平等及不良围产期结局相关。剥夺被描述为一个多维度概念,国际上已开发出综合指标(如基于地区的指标)来研究人群健康。

目的

本范围综述旨在研究中高收入国家已发表的关于地区层面剥夺与死产之间关系的文献。

方法

采用乔安娜·布里格斯循证卫生保健中心范围综述方法。研究问题基于人群(研究死产的研究)、概念(地区层面剥夺及其对死产的影响)、背景(中高收入国家)框架。检索了六个科学数据库。对结果进行筛选,并检索参考文献列表以识别相关文献。完成了关于研究特征的数据提取以及所提供的关联证据提取,并通过叙述性总结报告主要发现。

结果

共纳入29项研究,来自9个国家(大多数来自英国:n = 20),发表时间为1998年至2023年。使用了多种综合剥夺指数,英国的多重剥夺指数(IMD)最为常见(n = 8),其次是汤森指数和贾曼指数(分别为n = 6和n = 3)。收入、就业、教育和获得服务的机会是指数中作为剥夺衡量指标最常见的因素。29项研究中有22项(75.9%)显示死产与社会经济剥夺程度更高的地区之间存在正相关。

结论

本综述表明,地区层面剥夺似乎是中高收入国家死产的一个影响因素。针对处于较高剥夺相关风险人群采取有针对性的降低死产的举措,可能有助于改善孕产妇和围产期结局。

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