Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health

作者：Vogel J P^*; Souza J P; Mori R; Morisaki N; Lumbiganon P; Laopaiboon M; Ortiz Panozo E; Hernandez B; Perez Cuevas R; Roy M; Mittal S; Cecatti J G; Tuncalp Oe; Guelmezoglu A M

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2014, 121(s1): 76-88.

DOI：10.1111/1471-0528.12633

• Early neonatal death
• fetal death
• maternal complications
• perinatal mortality

ObjectiveWe aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications. %26lt;br%26gt;DesignSecondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS). %26lt;br%26gt;SettingA total of 359 participating facilities in 29 countries. %26lt;br%26gt;PopulationA total of 308 392 singleton deliveries. %26lt;br%26gt;MethodsWe reported on perinatal indicators and determined risks of perinatal death in the presence of severe maternal complications (haemorrhagic, infectious, and hypertensive disorders, and other medical conditions). %26lt;br%26gt;Main outcome measuresFresh and macerated LFDs (defined as stillbirths1000g and/or 28weeks of gestation) and ENDs. %26lt;br%26gt;ResultsThe LFD rate was 17.7 per 1000 births; 64.8% were fresh stillbirths. The END rate was 8.4 per 1000 liveborns; 67.1% occurred by day3 of life. Maternal complications were present in 85.6, 86.5, and 88.6% of macerated LFDs, fresh LFDs, and ENDs, respectively. The risks of all three perinatal mortality outcomes were significantly increased with placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, and severe anaemia. %26lt;br%26gt;ConclusionsPreventing intrapartum-related perinatal deaths requires a comprehensive approach to quality intrapartum care, beyond the provision of caesarean section. Early identification and management of women with complications could improve maternal and perinatal outcomes.

• 出版日期2014-3
• 单位河北医科大学