Sachs B P, Layde P M, Rubin G L, Rochat R W
JAMA. 1982 May 28;247(20):2789-92.
Maternal mortality in the United States has declined by 50% during the last decade. This decline took place at the same time as changes in the availability and use of contraceptive measures, including temporary contraceptives and sterilization. To examine the impact of these changes on mortality we estimated the reproductive mortality rate, which includes pregnancy-related deaths as well as deaths from the side effects of contraceptive methods. The estimated reproductive mortality rate fell by 73% from 1955 to 1975. The decrease was greater for women younger than 35 years. The slower decline for women aged 35 years and older was due to oral-contraception-related deaths. By 1975, pregnancy prevention was responsible for nearly as many deaths as pregnancy itself. The reproductive mortality rate is more appropriate than the maternal mortality rate for evaluating the health risks of reproduction and contraception. We urge that national surveillance of maternal mortality should be expanded to include deaths associated with contraceptive methods.
在过去十年中，美国的孕产妇死亡率下降了50%。这一下降与避孕措施（包括短效避孕药和绝育手术）的可获得性和使用情况的变化同时发生。为了研究这些变化对死亡率的影响，我们估算了生殖死亡率，其中包括与妊娠相关的死亡以及因避孕方法副作用导致的死亡。从1955年到1975年，估算的生殖死亡率下降了73%。35岁以下女性的下降幅度更大。35岁及以上女性下降较慢是由于与口服避孕药相关的死亡。到1975年，预防妊娠导致的死亡人数几乎与妊娠本身导致的死亡人数一样多。在评估生殖和避孕的健康风险方面，生殖死亡率比孕产妇死亡率更合适。我们敦促扩大全国孕产妇死亡率监测范围，将与避孕方法相关的死亡纳入其中。
