Puffer R R
Bull Pan Am Health Organ. 1993;27(2):120-34.
Both maternal and infant death rates in the United States are much higher than in many developed countries. The interrelationships between abortions and maternal and infant mortality have been analyzed on the basis of data from the 1970s and 1980s. The legalization of abortions in 1973 resulted in a marked increase in legal abortions and marked reductions in maternal and infant mortality over the course of the 1970s. However, a wide variation in abortion rates and in the number of abortion facilities indicates that such facilities were not readily available to all segments of the population in some areas. This probably accounts in part for higher maternal and infant death rates in such areas. Smoking, small weight gain, use of alcohol and drugs in pregnancy, and excessive maternal youth or age affected the outcome of pregnancy and contributed to high rates of infant death. Infant death rates were especially high among newborns of teenagers and young adult mothers; relatively high proportions of these newborns had low birthweights; a large share of the pregnancies involved were unintended; and slightly over half of the unintended pregnancies in teenagers and young women resulted in abortion. Comparisons with findings in Sweden reveal that the rates of unplanned pregnancy, abortion, and infant mortality were all much higher in the United States than in Sweden. The differences are attributed to better contraceptive services, which were made available free or very inexpensively in Sweden. Also, the frequency of low weight births was much lower in Sweden.
美国的孕产妇和婴儿死亡率均远高于许多发达国家。基于20世纪70年代和80年代的数据,对堕胎与孕产妇及婴儿死亡率之间的相互关系进行了分析。1973年堕胎合法化导致合法堕胎显著增加,并且在20世纪70年代期间孕产妇和婴儿死亡率显著下降。然而,堕胎率和堕胎机构数量差异很大,这表明在某些地区并非所有人群都能轻易获得此类机构的服务。这可能部分解释了这些地区较高的孕产妇和婴儿死亡率。吸烟、体重增加少、孕期饮酒和吸毒以及孕产妇过于年轻或年龄过大都会影响妊娠结局,并导致婴儿死亡率居高不下。青少年和年轻成年母亲所生新生儿的婴儿死亡率尤其高;这些新生儿中出生体重低的比例相对较高;其中很大一部分怀孕是意外怀孕;青少年和年轻女性中略超过一半的意外怀孕以堕胎告终。与瑞典的研究结果相比,美国意外怀孕、堕胎和婴儿死亡率均远高于瑞典。这些差异归因于瑞典提供了免费或非常廉价的更好的避孕服务。此外,瑞典低体重儿的发生率要低得多。