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全球孕产妇和新生儿疾病的负担和不平等:基于 2019 年全球疾病负担研究的数据。

Global burden and inequality of maternal and neonatal disorders: based on data from the 2019 Global Burden of Disease study.

机构信息

Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, Sichuan, 610081, China.

Department of Pediatrics, West China Second University Hospital, Sichuan University, Sichuan, 610041, China.

出版信息

QJM. 2024 Feb 7;117(1):24-37. doi: 10.1093/qjmed/hcad220.

Abstract

BACKGROUND

Maternal and neonatal disorders account for substantial health loss across the lifespan from early childhood. These problems may be related to health inequality.

AIM

To provide evidence for improvement in health policies regarding maternal and neonatal disorder inequity.

DESIGN

This was a population-based cross-sectional study based on 2019 Global Burden of Disease data.

METHODS

Annual cases and age-standardized rates (ASRs) of incidence, prevalence, death, and disability-adjusted life-years (DALYs) in maternal and neonatal disorders between 1990 and 2019 were collected from the 2019 Global Burden of Disease study. Concentration curves and concentration indices were used to summarize the degree of socioeconomic-related inequality.

RESULTS

For maternal disorders, the global ASRs of incidence, prevalence, death and DALYs were 2889.4 (95% uncertainty interval (UI), 2562.9-3251.9), 502.9 (95% UI 418.7-598.0), 5.0 (95% UI 4.4-5.8) and 324.9 (95% UI 284.0-369.1) per 100 000 women in 2019, respectively. The ASRs of maternal disorders were all obviously reduced and remained pro-poor from 1990 to 2019. In neonatal disorders, the global ASRs of incidence, prevalence, death and DALYs were 363.3 (95% UI 334.6-396.8), 1239.8 (95% UI 1142.1-1356.7), 29.1 (95% UI 24.8-34.5) and 2828.3 (95% UI 2441.6-3329.6) per 100 000 people in 2019, respectively. The global ASRs of incidence, death and DALYs in neonatal disorders have remained pro-poor. However, the socioeconomic-related fairness in the ASR of neonatal disorder prevalence is being levelled.

CONCLUSIONS

The global burden of maternal and neonatal disorders has remained high, and socioeconomic-related inequality (pro-poor) tended not to change between 1990 and 2019.

摘要

背景

母婴疾病在整个生命周期内都会导致大量健康损失,包括儿童早期。这些问题可能与健康不平等有关。

目的

为改善母婴疾病的卫生政策提供证据,以解决不平等问题。

设计

这是一项基于 2019 年全球疾病负担数据的基于人群的横断面研究。

方法

从 2019 年全球疾病负担研究中收集了 1990 年至 2019 年期间母婴疾病的年度病例数和年龄标准化发病率(ASR)、患病率、死亡率和伤残调整生命年(DALY)。使用集中曲线和集中指数来总结与社会经济相关的不平等程度。

结果

对于母婴疾病,全球 2019 年发病率、患病率、死亡率和 DALY 的 ASR 分别为 2889.4(95%置信区间[95%UI]为 2562.9-3251.9)、502.9(95%UI 为 418.7-598.0)、5.0(95%UI 为 4.4-5.8)和 324.9(95%UI 为 284.0-369.1)/100000 名妇女。1990 年至 2019 年,母婴疾病的 ASR 均明显下降,且一直有利于贫困人口。在新生儿疾病方面,全球 2019 年发病率、患病率、死亡率和 DALY 的 ASR 分别为 363.3(95%UI 为 334.6-396.8)、1239.8(95%UI 为 1142.1-1356.7)、29.1(95%UI 为 24.8-34.5)和 2828.3(95%UI 为 2441.6-3329.6)/100000 人。新生儿疾病的发病率、死亡率和 DALY 的全球 ASR 一直有利于贫困人口。然而,新生儿疾病患病率的社会经济相关公平性正在趋于平等。

结论

全球母婴疾病负担仍然很高,1990 年至 2019 年期间,与社会经济相关的不平等(有利于贫困人口)趋势没有变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e2e/10849872/70e28867e10b/hcad220f1.jpg

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