Galvan J, Woelk G B, Mahomed K, Wagner N, Mudzamiri S, Williams M A
Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, USA.
Cent Afr J Med. 2001 Apr;47(4):87-92.
To examine the association between adverse infant outcomes and maternal under utilization of prenatal care, among women delivering at Harare Maternity Hospital.
Hospital based, cross sectional study.
Harare Maternity Hospital, Harare, Zimbabwe.
A random sample of 3,864 pregnant women.
Prenatal care utilization, maternal socio-demographic information, as well as birth weight and other neonatal outcome characteristics.
Of the total number of women who participated in this study 3,491 (90%) had at least one prenatal care visit. Women receiving no prenatal care, were more likely to be younger, unmarried and to have been transferred for delivery as compared with women receiving prenatal care. Women receiving no prenatal care were seven times more likely to deliver an infant weighing less than 1,500 grams, adjusted odd ratio (OR) = 7.22; 95% confidence interval (CI) 4.58 to 11.39 as compared with those who booked for care. Newborns of unbooked mothers were more likely to have a low apgar score at birth, adjusted OR = 1.71; to have been admitted to the neonatal intensive care unit, adjusted OR = 2.14, and to require intubation, adjusted OR = 3.35. A large proportion of women (31.4%) initiated prenatal care after 30 weeks gestation.
There were significant differences between maternal characteristics and foetal outcomes in relation to booking status. Under utilization of prenatal care was associated with sub-optimal foetal outcomes. Improving the socio-economic status of women, their education and access to health care, and family planning methods are all strategies that should contribute to the reduction of adverse foetal outcomes.
在哈拉雷妇产医院分娩的妇女中，研究不良婴儿结局与孕产妇产前保健利用不足之间的关联。
基于医院的横断面研究。
津巴布韦哈拉雷的哈拉雷妇产医院。
3864名孕妇的随机样本。
产前保健利用情况、孕产妇社会人口学信息以及出生体重和其他新生儿结局特征。
参与本研究的妇女中，3491名（90%）至少进行了一次产前检查。与接受产前保健的妇女相比，未接受产前保健的妇女更年轻、未婚且更多是转院来分娩的。未接受产前保健的妇女分娩体重不足1500克婴儿的可能性高出7倍，调整后的比值比（OR）=7.22；95%置信区间（CI）为4.58至11.39，而那些预约保健的妇女则较低。未预约母亲的新生儿出生时阿氏评分低的可能性更大，调整后的OR = 1.71；入住新生儿重症监护病房的可能性更大，调整后的OR = 2.14，需要插管的可能性更大，调整后的OR = 3.35。很大一部分妇女（31.4%）在妊娠30周后才开始产前保健。
在预约状态方面，孕产妇特征和胎儿结局存在显著差异。产前保健利用不足与胎儿结局欠佳有关。改善妇女的社会经济地位、教育水平、获得医疗保健的机会以及计划生育方法都是有助于减少不良胎儿结局的策略。
