Document Detail


Pregnancy-related death and health care services.
MedLine Citation:
PMID:  12907099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the association between health care services variables and pregnancy-related death using a contemporary geographically defined population and enhanced methods for case identification. METHODS: This is a population-based, case-control study from North Carolina for the 7-year period 1992-1998. Pregnancy-related deaths after a live birth (n = 118) were identified after review of pregnancy-associated deaths (n = 400) ascertained from death certificate codes and linkage of birth and death files. Controls (n = 3697) were randomly selected from all registered live births for the same 7-year period and were not matched with cases. This sample size was sufficient to ensure that the standard errors for subgroup prevalences were less than 1%. The associations between pregnancy-related death and health care services were explored with univariate and multivariable regression analysis. RESULTS: Neither maternity care coordination nor nutritional services were protective. There was no association with source of care, private versus public. The adjusted odds ratio (OR) for pregnancy-related death associated with cesarean delivery was 3.9 (95% confidence interval [CI] 2.5, 6.1). The adjusted OR for pregnancy-related death associated with the receipt of prenatal care was 0.2 (95% CI 0.1, 0.6). CONCLUSION: Removing barriers to and actively promoting use of prenatal care services and decreasing the rate of cesarean deliveries could decrease the number of pregnancy-related deaths.
Authors:
Margaret A Harper; Robert P Byington; Mark A Espeland; Michelle Naughton; Robert Meyer; Kathy Lane
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-08     Completed Date:  2003-08-29     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. mharper@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Cesarean Section / mortality
Female
Humans
Maternal Mortality*
North Carolina / epidemiology
Odds Ratio
Prenatal Care*
Regression Analysis
Grant Support
ID/Acronym/Agency:
5K12HD01267/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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