一项基于社区的孕产妇死亡率巢式病例对照研究。
A community-based nested case-control study of maternal mortality.
作者信息
Fikree F F, Gray R H, Berendes H W, Karim M S
机构信息
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
出版信息
Int J Gynaecol Obstet. 1994 Dec;47(3):247-55. doi: 10.1016/0020-7292(94)90569-x.
OBJECTIVES
Population-based information from Pakistan on maternal mortality is inadequate to define the magnitude of the problem or to contribute information on the distribution of clinical causes and risk factors. A population-based survey was conducted in eight urban squatter settlements of Karachi, Pakistan, to address these key issues.
METHODS
Pre-coded questionnaires were administered to the 10,135 households to ascertain deaths of household members in the 5 years preceding the survey (1984-1989). A verbal autopsy questionnaire was administered to the 121 households where a female death between 15 and 49 years of age was reported.
RESULTS
The maternal mortality ratio was estimated as 281 per 100,000 livebirths with hemorrhage, eclampsia and puerperal sepsis as the major causes of maternal deaths. Important risk factors identified were maternal employment, paternal unemployment, and poor prior pregnancy history. Women did seek health care but the assistance sought was often inappropriate.
CONCLUSION
Intervention programs for improving timely referral and upgrading of hospitals are suggested.
目的
来自巴基斯坦的基于人群的孕产妇死亡率信息不足以界定该问题的严重程度，也无法提供有关临床病因和风险因素分布的信息。在巴基斯坦卡拉奇的八个城市棚户区进行了一项基于人群的调查，以解决这些关键问题。
方法
向10135户家庭发放预先编码的问卷，以确定在调查前5年（1984 - 1989年）家庭成员的死亡情况。向报告有15至49岁女性死亡的121户家庭发放了口头尸检问卷。
结果
估计孕产妇死亡率为每10万活产281例，出血、子痫和产褥期败血症是孕产妇死亡的主要原因。确定的重要风险因素包括孕产妇就业、父亲失业以及既往不良孕产史。妇女确实寻求医疗保健，但所寻求的帮助往往不恰当。
结论
建议开展干预项目，以改善及时转诊并提升医院水平。
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