Zahra Shahin, Isabella Hardwick, Nancy Jeffery, J. Jordan, William Mase
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引用次数: 0
Abstract
Background: The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and recommending policy implications to seek to reduce the MMR. Methods: This study conducted a comprehensive literature review from the online database and also used data from CDC Wonder, OASIS Georgia, and Georgia Department of Public Health website to identify the primary antecedents of elevated MMR among African American women in the State of Georgia with specific attention to policy and ethical considerations. Results: This review found factors that were related to causes of maternal death in the U.S. include socioeconomic status, communication between patient and healthcare provider, and maternal medical conditions and complications during pregnancy. In the State of Georgia, complications during pregnancy and cardiomyopathy were the leading cause of MMR, particularly among African American women in comparison with other races. However, inconsistency in reporting maternal death data was another issue that is discussed in this review. Conclusions: Policies that incorporate ethical considerations need to be developed to benefit the family and society. Policymakers should seek to develop targeted policies in support of specific vulnerable populations through improving maternal screening, health promotion, behavior uptake, and effective case management.
背景:美国是目前孕产妇死亡率(MMR)比15年前更糟糕的13个国家之一。降低孕产妇死亡率是美国卫生系统面临的重大挑战之一,尤其是在美国孕产妇死亡率最高的州之一乔治亚州。本综述的目的是探讨导致佐治亚州非裔美国妇女孕产妇死亡率上升的原因、政策和伦理背景因素。此外,确定和解决卫生保健系统中存在的弱点和差距,并建议政策影响,以寻求减少MMR。方法:本研究从在线数据库中进行了全面的文献综述,并使用了CDC Wonder、OASIS Georgia和Georgia Department of Public Health网站的数据,以确定佐治亚州非裔美国妇女MMR升高的主要前因,并特别注意政策和伦理考虑。结果:本综述发现与美国孕产妇死亡原因相关的因素包括社会经济地位、患者与医疗保健提供者之间的沟通、孕产妇医疗状况和妊娠期间的并发症。在佐治亚州,与其他种族相比,妊娠期并发症和心肌病是MMR的主要原因,特别是在非裔美国妇女中。然而,报告产妇死亡数据的不一致是本综述讨论的另一个问题。结论:需要制定纳入伦理考虑的政策,以造福家庭和社会。决策者应通过改进孕产妇筛查、健康促进、行为吸收和有效的病例管理,寻求制定有针对性的政策,以支持特定的弱势群体。