Zhou Xu, Wu Yinglan, Gao Jie, Chen Xiaoying, Wang Aihua, Fang Junqun
Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
BMC Public Health. 2024 Dec 18;24(1):3466. doi: 10.1186/s12889-024-20989-6.
To explore the relationship between pregnancy complications and maternal near-miss (MNM).
Data were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012-2022. The MNM ratio refers to the number of MNM per 1000 live births, and maternal mortality refers to the number of maternal deaths per 100,000 live births. Chi-square trend tests (χ) were used to determine trends in proportions by year. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for MNM.
Our study included 780,359 women with 731,185 live births, a total of 2461 MNMs, and 52 maternal deaths were identified. The MNM ratio was 3.37‰ (95%CI: 3.23-3.50), and the maternal mortality was 7.11 per 100,000 live births (95%CI: 5.18-9.04). Coagulation/hematological dysfunction was the most common cause of MNM (75.66%). From 2012 to 2022, the proportion of coagulation/hematological dysfunction among MNM increased from 49.14% in 2012 to 86.39% in 2022, which was the only cause of MNM that showed an increased trend (χ = 7.43, P = 0.01). Results of multivariate logistic regression analysis showed that 10 pregnancy complications were risk factors for MNM: hemorrhage disorder (aOR = 21.50, 95%CI: 19.64-23.54), infections (aOR = 1.91, 95%CI: 1.64-2.22), hypertension (aOR = 4.50, 95%CI: 4.08-4.98), heart disease (aOR = 14.96, 95%CI: 11.51-19.44), embolic disease (aOR = 171.70, 95%CI: 94.08-313.36), liver disease (aOR = 1.54, 95%CI: 1.25-1.90), anaemia (aOR = 4.72, 95%CI: 4.29-5.19), renal disease (aOR = 5.44, 95%CI: 4.00-7.40), pulmonary disease (aOR = 14.85, 95%CI: 8.33-26.50), and connective tissue disease (aOR = 5.15, 95%CI: 3.06-8.66).
The MNM ratio was relatively low in Hunan Province. Several pregnancy complications increased the risk of MNM. It is helpful for clinical counseling and public health policies, which may contribute to preventing MNM.
探讨妊娠并发症与孕产妇严重近距 misses（MNM）之间的关系。
数据来源于中国湖南省2012 - 2022年孕产妇严重近距 misses监测系统。MNM比率指每1000例活产中MNM的数量，孕产妇死亡率指每100,000例活产中孕产妇死亡的数量。采用卡方趋势检验（χ）确定各年份比例的趋势。多元逻辑回归分析（方法：向前，Wald，α = 0.05）和调整后的优势比（aORs）用于确定MNM的危险因素。
我们的研究纳入了780,359名妇女，有731,185例活产，共识别出2461例MNM，以及52例孕产妇死亡。MNM比率为3.37‰（95%CI：3.23 - 3.50），孕产妇死亡率为每100,000例活产7.11例（95%CI：5.18 - 9.04）。凝血/血液学功能障碍是MNM最常见的原因（75.66%）。从2012年到2022年，MNM中凝血/血液学功能障碍的比例从2012年的49.14%增加到2022年的86.39%，这是唯一呈上升趋势的MNM原因（χ = 7.43，P = 0.01）。多元逻辑回归分析结果显示，10种妊娠并发症是MNM的危险因素：出血性疾病（aOR = 21.50，95%CI：19.64 - 23.54）、感染（aOR = 1.91，95%CI：1.64 - 2.22）、高血压（aOR = 4.50，95%CI：4.08 - 4.98）、心脏病（aOR = 14.96，95%CI：11.51 - 19.44）、栓塞性疾病（aOR = 171.70，95%CI：94.08 - 313.36）、肝病（aOR = 1.54，95%CI：1.25 - 1.90）、贫血（aOR = 4.72，95%CI：4.29 - 5.19）、肾病（aOR = 5.44，95%CI：4.00 - 7.40）、肺病（aOR = 14.85，95%CI：8.33 - 26.50）和结缔组织病（aOR = 5.15，95%CI：3.06 - 8.66）。
湖南省的MNM比率相对较低。几种妊娠并发症增加了MNM的风险。这有助于临床咨询和公共卫生政策，可能有助于预防MNM。
