Berg C J, Atrash H K, Koonin L M, Tucker M
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Obstet Gynecol. 1996 Aug;88(2):161-7. doi: 10.1016/0029-7844(96)00135-4.
To use data from the Centers for Disease Control and Prevention's (CDC) Pregnancy-Related Mortality Surveillance System to examine trends in pregnancy-related mortality and risk factors for pregnancy-related death.
In collaboration with ACOG and state health departments, the Pregnancy-Related Mortality Surveillance System has collected information on all deaths caused by pregnancy since 1979. Multiple data sources were used, including national death files, state health departments, maternal mortality review committees, individuals, and the media. As part of the initiation of the Pregnancy-Related Mortality Surveillance System in 1987, CDC staff contacted state health department personnel and encouraged them to identify and report pregnancy-related deaths. Data were reviewed and coded by experienced clinicians. Pregnancy-related mortality ratios (pregnancy-related deaths per 100,000 live births) were calculated.
After decreasing annually after 1979, the reported pregnancy-related mortality ratio increased from 7.2 in 1987 to 10.0 in 1990. This increase occurred among women of all races. A higher risk of pregnancy-related death was found with increasing maternal age, increasing live-birth order, no prenatal care, and among unmarried women. The leading causes of pregnancy-related death were hemorrhage, embolism, and hypertensive disorders of pregnancy. During the periods 1979-1986 and 1987-1990, the cause-specific pregnancy-related mortality ratios decreased for deaths due to hemorrhage and anesthesia, whereas pregnancy-related mortality ratios due to cardiomyopathy and infection increased. The leading causes of death varied according to the outcome of the pregnancy.
Increased efforts to identify pregnancy-related deaths have contributed to an increase in the reported pregnancy-related mortality ratio. More than half of such deaths, however, are probably still unreported. Adequate surveillance of pregnancy-related mortality and morbidity is necessary for interpreting trends, identifying high-risk groups, and developing effective interventions.
利用疾病控制与预防中心（CDC）的妊娠相关死亡监测系统的数据，研究妊娠相关死亡率的趋势以及妊娠相关死亡的危险因素。
妊娠相关死亡监测系统与美国妇产科医师学会（ACOG）及各州卫生部门合作，收集了自1979年以来所有由妊娠导致的死亡信息。使用了多个数据源，包括国家死亡档案、各州卫生部门、孕产妇死亡审查委员会、个人及媒体。作为1987年启动妊娠相关死亡监测系统的一部分，CDC工作人员联系了各州卫生部门人员，鼓励他们识别并报告妊娠相关死亡。数据由经验丰富的临床医生进行审查和编码。计算了妊娠相关死亡率（每10万例活产中的妊娠相关死亡数）。
1979年后每年下降的妊娠相关死亡率从1987年的7.2上升至1990年的10.0。所有种族的女性中均出现了这种上升。发现随着孕产妇年龄增加、活产次数增加、未接受产前护理以及未婚女性，妊娠相关死亡风险更高。妊娠相关死亡的主要原因是出血、栓塞和妊娠高血压疾病。在1979 - 198
