Медицинская библиотека · Lancet (London, England) · 2014
Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Kassebaum Nicholas J, Bertozzi-Villa Amelia, Coggeshall Megan S, Shackelford Katya A, Steiner Caitlyn, Heuton Kyle R, Gonzalez-Medina Diego, Barber Ryan, Huynh Chantal, Dicker Daniel, Templin Tara, Wolock Timothy M, Ozgoren Ayse Abbasoglu, Abd-Allah Foad, Abera Semaw Ferede, Abubakar Ibrahim, Achoki Tom, Adelekan Ademola, Ademi Zanfina, Adou Arsène Kouablan, Adsuar José C, Agardh Emilie E, Akena Dickens, Alasfoor Deena, Alemu Zewdie Aderaw, Alfonso-Cristancho Rafael, Alhabib Samia, Ali Raghib, Al Kahbouri Mazin J, Alla François, Allen Peter J, AlMazroa Mohammad A, Alsharif Ubai, Alvarez Elena, Alvis-Guzmán Nelson, Amankwaa Adansi A, Amare Azmeraw T, Amini Hassan, Ammar Walid, Antonio Carl A T, Anwari Palwasha, Arnlöv Johan, Arsenijevic Valentina S Arsic, Artaman Ali, Asad Majed Masoud, Asghar Rana J, Assadi Reza, Atkins Lydia S, Badawi Alaa, Balakrishnan Kalpana, Basu Arindam, Basu Sanjay, Beardsley Justin, Bedi Neeraj, Bekele Tolesa, Bell Michelle L, Bernabe Eduardo, Beyene Tariku J, Bhutta Zulfiqar, Bin Abdulhak Aref, Blore Jed D, Basara Berrak Bora, Bose Dipan, Breitborde Nicholas, Cárdenas Rosario, Castañeda-Orjuela Carlos A, Castro Ruben Estanislao, Catalá-López Ferrán, Cavlin Alanur, Chang Jung-Chen, Che Xuan, Christophi Costas A, Chugh Sumeet S, Cirillo Massimo, Colquhoun Samantha M, Cooper Leslie Trumbull, Cooper Cyrus, da Costa Leite Iuri, Dandona Lalit, Dandona Rakhi, Davis Adrian, Dayama Anand, Degenhardt Louisa, De Leo Diego, del Pozo-Cruz Borja, Deribe Kebede, Dessalegn Muluken, deVeber Gabrielle A, Dharmaratne Samath D, Dilmen Uğur, Ding Eric L, Dorrington Rob E, Driscoll Tim R, Ermakov Sergei Petrovich, Esteghamati Alireza, Faraon Emerito Jose A, Farzadfar Farshad, Felicio Manuela Mendonca, Fereshtehnejad Seyed-Mohammad, de Lima Graça Maria Ferreira, Forouzanfar Mohammad H, França Elisabeth B, Gaffikin Lynne, Gambashidze Ketevan, Gankpé Fortuné Gbètoho, Garcia Ana C, Geleijnse Johanna M, Gibney Katherine B, Giroud Maurice, Glaser Elizabeth L, Goginashvili Ketevan, Gona Philimon, González-Castell Dinorah, Goto Atsushi, Gouda Hebe N, Gugnani Harish Chander, Gupta Rahul, Gupta Rajeev, Hafezi-Nejad Nima, Hamadeh Randah Ribhi, Hammami Mouhanad, Hankey Graeme J, Harb Hilda L, Havmoeller Rasmus, Hay Simon I, Pi Ileana B Heredia, Hoek Hans W, Hosgood H Dean, Hoy Damian G, Husseini Abdullatif, Idrisov Bulat T, Innos Kaire, Inoue Manami, Jacobsen Kathryn H, Jahangir Eiman, Jee Sun Ha, Jensen Paul N, Jha Vivekanand, Jiang Guohong, Jonas Jost B, Juel Knud, Kabagambe Edmond Kato, Kan Haidong, Karam Nadim E, Karch André, Karema Corine Kakizi, Kaul Anil, Kawakami Norito, Kazanjan Konstantin, Kazi Dhruv S, Kemp Andrew H, Kengne Andre Pascal, Kereselidze Maia, Khader Yousef Saleh, Khalifa Shams Eldin Ali Hassan, Khan Ejaz Ahmed, Khang Young-Ho, Knibbs Luke, Kokubo Yoshihiro, Kosen Soewarta, Defo Barthelemy Kuate, Kulkarni Chanda, Kulkarni Veena S, Kumar G Anil, Kumar Kaushalendra, Kumar Ravi B, Kwan Gene, Lai Taavi, Lalloo Ratilal, Lam Hilton, Lansingh Van C, Larsson Anders, Lee Jong-Tae, Leigh James, Leinsalu Mall, Leung Ricky, Li Xiaohong, Li Yichong, Li Yongmei, Liang Juan, Liang Xiaofeng, Lim Stephen S, Lin Hsien-Ho, Lipshultz Steven E, Liu Shiwei, Liu Yang, Lloyd Belinda K, London Stephanie J, Lotufo Paulo A, Ma Jixiang, Ma Stefan, Machado Vasco Manuel Pedro, Mainoo Nana Kwaku, Majdan Marek, Mapoma Christopher Chabila, Marcenes Wagner, Marzan Melvin Barrientos, Mason-Jones Amanda J, Mehndiratta Man Mohan, Mejia-Rodriguez Fabiola, Memish Ziad A, Mendoza Walter, Miller Ted R, Mills Edward J, Mokdad Ali H, Mola Glen Liddell, Monasta Lorenzo, de la Cruz Monis Jonathan, Hernandez Julio Cesar Montañez, Moore Ami R, Moradi-Lakeh Maziar, Mori Rintaro, Mueller Ulrich O, Mukaigawara Mitsuru, Naheed Aliya, Naidoo Kovin S, Nand Devina, Nangia Vinay, Nash Denis, Nejjari Chakib, Nelson Robert G, Neupane Sudan Prasad, Newton Charles R, Ng Marie, Nieuwenhuijsen Mark J, Nisar Muhammad Imran, Nolte Sandra, Norheim Ole F, Nyakarahuka Luke, Oh In-Hwan, Ohkubo Takayoshi, Olusanya Bolajoko O, Omer Saad B, Opio John Nelson, Orisakwe Orish Ebere, Pandian Jeyaraj D, Papachristou Christina, Park Jae-Hyun, Caicedo Angel J Paternina, Patten Scott B, Paul Vinod K, Pavlin Boris Igor, Pearce Neil, Pereira David M, Pesudovs Konrad, Petzold Max, Poenaru Dan, Polanczyk Guilherme V, Polinder Suzanne, Pope Dan, Pourmalek Farshad, Qato Dima, Quistberg D Alex, Rafay Anwar, Rahimi Kazem, Rahimi-Movaghar Vafa, ur Rahman Sajjad, Raju Murugesan, Rana Saleem M, Refaat Amany, Ronfani Luca, Roy Nobhojit, Pimienta Tania Georgina Sánchez, Sahraian Mohammad Ali, Salomon Joshua A, Sampson Uchechukwu, Santos Itamar S, Sawhney Monika, Sayinzoga Felix, Schneider Ione J C, Schumacher Austin, Schwebel David C, Seedat Soraya, Sepanlou Sadaf G, Servan-Mori Edson E, Shakh-Nazarova Marina, Sheikhbahaei Sara, Shibuya Kenji, Shin Hwashin Hyun, Shiue Ivy, Sigfusdottir Inga Dora, Silberberg Donald H, Silva Andrea P, Singh Jasvinder A, Skirbekk Vegard, Sliwa Karen, Soshnikov Sergey S, Sposato Luciano A, Sreeramareddy Chandrashekhar T, Stroumpoulis Konstantinos, Sturua Lela, Sykes Bryan L, Tabb Karen M, Talongwa Roberto Tchio, Tan Feng, Teixeira Carolina Maria, Tenkorang Eric Yeboah, Terkawi Abdullah Sulieman, Thorne-Lyman Andrew L, Tirschwell David L, Towbin Jeffrey A, Tran Bach X, Tsilimbaris Miltiadis, Uchendu Uche S, Ukwaja Kingsley N, Undurraga Eduardo A, Uzun Selen Begüm, Vallely Andrew J, van Gool Coen H, Vasankari Tommi J, Vavilala Monica S, Venketasubramanian N, Villalpando Salvador, Violante Francesco S, Vlassov Vasiliy Victorovich, Vos Theo, Waller Stephen, Wang Haidong, Wang Linhong, Wang XiaoRong, Wang Yanping, Weichenthal Scott, Weiderpass Elisabete, Weintraub Robert G, Westerman Ronny, Wilkinson James D, Woldeyohannes Solomon Meseret, Wong John Q, Wordofa Muluemebet Abera, Xu Gelin, Yang Yang C, Yano Yuichiro, Yentur Gokalp Kadri, Yip Paul, Yonemoto Naohiro, Yoon Seok-Jun, Younis Mustafa Z, Yu Chuanhua, Jin Kim Yun, El Sayed Zaki Maysaa, Zhao Yong, Zheng Yingfeng, Zhou Maigeng, Zhu Jun, Zou Xiao Nong, Lopez Alan D, Naghavi Mohsen, Murray Christopher J L, Lozano Rafael
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАПеревод в очереди
Аннотация
BACKGROUND
The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.
METHODS
We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.
FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.
INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.
FUNDING: Bill & Melinda Gates Foundation.
Для цитирования: Kassebaum Nicholas J, Bertozzi-Villa Amelia, Coggeshall Megan S, Shackelford Katya A, Steiner Caitlyn, Heuton Kyle R, Gonzalez-Medina Diego, Barber Ryan, Huynh Chantal, Dicker Daniel, Templin Tara, Wolock Timothy M, Ozgoren Ayse Abbasoglu, Abd-Allah Foad, Abera Semaw Ferede, Abubakar Ibrahim, Achoki Tom, Adelekan Ademola, Ademi Zanfina, Adou Arsène Kouablan, Adsuar José C, Agardh Emilie E, Akena Dickens, Alasfoor Deena, Alemu Zewdie Aderaw, Alfonso-Cristancho Rafael, Alhabib Samia, Ali Raghib, Al Kahbouri Mazin J, Alla François, Allen Peter J, AlMazroa Mohammad A, Alsharif Ubai, Alvarez Elena, Alvis-Guzmán Nelson, Amankwaa Adansi A, Amare Azmeraw T, Amini Hassan, Ammar Walid, Antonio Carl A T, Anwari Palwasha, Arnlöv Johan, Arsenijevic Valentina S Arsic, Artaman Ali, Asad Majed Masoud, Asghar Rana J, Assadi Reza, Atkins Lydia S, Badawi Alaa, Balakrishnan Kalpana, Basu Arindam, Basu Sanjay, Beardsley Justin, Bedi Neeraj, Bekele Tolesa, Bell Michelle L, Bernabe Eduardo, Beyene Tariku J, Bhutta Zulfiqar, Bin Abdulhak Aref, Blore Jed D, Basara Berrak Bora, Bose Dipan, Breitborde Nicholas, Cárdenas Rosario, Castañeda-Orjuela Carlos A, Castro Ruben Estanislao, Catalá-López Ferrán, Cavlin Alanur, Chang Jung-Chen, Che Xuan, Christophi Costas A, Chugh Sumeet S, Cirillo Massimo, Colquhoun Samantha M, Cooper Leslie Trumbull, Cooper Cyrus, da Costa Leite Iuri, Dandona Lalit, Dandona Rakhi, Davis Adrian, Dayama Anand, Degenhardt Louisa, De Leo Diego, del Pozo-Cruz Borja, Deribe Kebede, Dessalegn Muluken, deVeber Gabrielle A, Dharmaratne Samath D, Dilmen Uğur, Ding Eric L, Dorrington Rob E, Driscoll Tim R, Ermakov Sergei Petrovich, Esteghamati Alireza, Faraon Emerito Jose A, Farzadfar Farshad, Felicio Manuela Mendonca, Fereshtehnejad Seyed-Mohammad, de Lima Graça Maria Ferreira, Forouzanfar Mohammad H, França Elisabeth B, Gaffikin Lynne, Gambashidze Ketevan, Gankpé Fortuné Gbètoho, Garcia Ana C, Geleijnse Johanna M, Gibney Katherine B, Giroud Maurice, Glaser Elizabeth L, Goginashvili Ketevan, Gona Philimon, González-Castell Dinorah, Goto Atsushi, Gouda Hebe N, Gugnani Harish Chander, Gupta Rahul, Gupta Rajeev, Hafezi-Nejad Nima, Hamadeh Randah Ribhi, Hammami Mouhanad, Hankey Graeme J, Harb Hilda L, Havmoeller Rasmus, Hay Simon I, Pi Ileana B Heredia, Hoek Hans W, Hosgood H Dean, Hoy Damian G, Husseini Abdullatif, Idrisov Bulat T, Innos Kaire, Inoue Manami, Jacobsen Kathryn H, Jahangir Eiman, Jee Sun Ha, Jensen Paul N, Jha Vivekanand, Jiang Guohong, Jonas Jost B, Juel Knud, Kabagambe Edmond Kato, Kan Haidong, Karam Nadim E, Karch André, Karema Corine Kakizi, Kaul Anil, Kawakami Norito, Kazanjan Konstantin, Kazi Dhruv S, Kemp Andrew H, Kengne Andre Pascal, Kereselidze Maia, Khader Yousef Saleh, Khalifa Shams Eldin Ali Hassan, Khan Ejaz Ahmed, Khang Young-Ho, Knibbs Luke, Kokubo Yoshihiro, Kosen Soewarta, Defo Barthelemy Kuate, Kulkarni Chanda, Kulkarni Veena S, Kumar G Anil, Kumar Kaushalendra, Kumar Ravi B, Kwan Gene, Lai Taavi, Lalloo Ratilal, Lam Hilton, Lansingh Van C, Larsson Anders, Lee Jong-Tae, Leigh James, Leinsalu Mall, Leung Ricky, Li Xiaohong, Li Yichong, Li Yongmei, Liang Juan, Liang Xiaofeng, Lim Stephen S, Lin Hsien-Ho, Lipshultz Steven E, Liu Shiwei, Liu Yang, Lloyd Belinda K, London Stephanie J, Lotufo Paulo A, Ma Jixiang, Ma Stefan, Machado Vasco Manuel Pedro, Mainoo Nana Kwaku, Majdan Marek, Mapoma Christopher Chabila, Marcenes Wagner, Marzan Melvin Barrientos, Mason-Jones Amanda J, Mehndiratta Man Mohan, Mejia-Rodriguez Fabiola, Memish Ziad A, Mendoza Walter, Miller Ted R, Mills Edward J, Mokdad Ali H, Mola Glen Liddell, Monasta Lorenzo, de la Cruz Monis Jonathan, Hernandez Julio Cesar Montañez, Moore Ami R, Moradi-Lakeh Maziar, Mori Rintaro, Mueller Ulrich O, Mukaigawara Mitsuru, Naheed Aliya, Naidoo Kovin S, Nand Devina, Nangia Vinay, Nash Denis, Nejjari Chakib, Nelson Robert G, Neupane Sudan Prasad, Newton Charles R, Ng Marie, Nieuwenhuijsen Mark J, Nisar Muhammad Imran, Nolte Sandra, Norheim Ole F, Nyakarahuka Luke, Oh In-Hwan, Ohkubo Takayoshi, Olusanya Bolajoko O, Omer Saad B, Opio John Nelson, Orisakwe Orish Ebere, Pandian Jeyaraj D, Papachristou Christina, Park Jae-Hyun, Caicedo Angel J Paternina, Patten Scott B, Paul Vinod K, Pavlin Boris Igor, Pearce Neil, Pereira David M, Pesudovs Konrad, Petzold Max, Poenaru Dan, Polanczyk Guilherme V, Polinder Suzanne, Pope Dan, Pourmalek Farshad, Qato Dima, Quistberg D Alex, Rafay Anwar, Rahimi Kazem, Rahimi-Movaghar Vafa, ur Rahman Sajjad, Raju Murugesan, Rana Saleem M, Refaat Amany, Ronfani Luca, Roy Nobhojit, Pimienta Tania Georgina Sánchez, Sahraian Mohammad Ali, Salomon Joshua A, Sampson Uchechukwu, Santos Itamar S, Sawhney Monika, Sayinzoga Felix, Schneider Ione J C, Schumacher Austin, Schwebel David C, Seedat Soraya, Sepanlou Sadaf G, Servan-Mori Edson E, Shakh-Nazarova Marina, Sheikhbahaei Sara, Shibuya Kenji, Shin Hwashin Hyun, Shiue Ivy, Sigfusdottir Inga Dora, Silberberg Donald H, Silva Andrea P, Singh Jasvinder A, Skirbekk Vegard, Sliwa Karen, Soshnikov Sergey S, Sposato Luciano A, Sreeramareddy Chandrashekhar T, Stroumpoulis Konstantinos, Sturua Lela, Sykes Bryan L, Tabb Karen M, Talongwa Roberto Tchio, Tan Feng, Teixeira Carolina Maria, Tenkorang Eric Yeboah, Terkawi Abdullah Sulieman, Thorne-Lyman Andrew L, Tirschwell David L, Towbin Jeffrey A, Tran Bach X, Tsilimbaris Miltiadis, Uchendu Uche S, Ukwaja Kingsley N, Undurraga Eduardo A, Uzun Selen Begüm, Vallely Andrew J, van Gool Coen H, Vasankari Tommi J, Vavilala Monica S, Venketasubramanian N, Villalpando Salvador, Violante Francesco S, Vlassov Vasiliy Victorovich, Vos Theo, Waller Stephen, Wang Haidong, Wang Linhong, Wang XiaoRong, Wang Yanping, Weichenthal Scott, Weiderpass Elisabete, Weintraub Robert G, Westerman Ronny, Wilkinson James D, Woldeyohannes Solomon Meseret, Wong John Q, Wordofa Muluemebet Abera, Xu Gelin, Yang Yang C, Yano Yuichiro, Yentur Gokalp Kadri, Yip Paul, Yonemoto Naohiro, Yoon Seok-Jun, Younis Mustafa Z, Yu Chuanhua, Jin Kim Yun, El Sayed Zaki Maysaa, Zhao Yong, Zheng Yingfeng, Zhou Maigeng, Zhu Jun, Zou Xiao Nong, Lopez Alan D, Naghavi Mohsen, Murray Christopher J L, Lozano Rafael. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet (London, England). 2014. DOI: 10.1016/s0140-6736(14)60696-6.
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