Hinderaker Sven G, Olsen Bjørg E, Bergsjø Per B, Gasheka Peter, Lie Rolv T, Kvåle Gunnar
Center for International Health, University of Bergen, Norway.
J Health Popul Nutr. 2003 Mar;21(1):8-17.
The study was conducted to investigate the association between perinatal mortalityand factors relating to nutrition and infections in a rural population in northern Tanzania. A cohort of 3,618 women attending antenatal clinics was registered with background information and the results of antenatal examinations, and followed up after delivery. Stillbirths and neonatal deaths were identified and traced for an interview with the closest relatives. No information on outcome of pregnancy was obtained for seven women, and incomplete information was obtained for 99. The perinatal mortality rate was 27/1,000 births [95% confidence interval (CI) 22/1,000-33/1,000]; 44% were early neonatal deaths; and 56% were stillborn. There was an increased risk of perinatal death among babies with low birth-weight [for babies weighing 2,000-2,499 g, adjusted odds ratio (AOR) 5.8, 95% CI 2.1-15.8, babies below 2,000 g AOR 45.7; 95% CI 18.3-114.1], babies of women with a small arm circumference (below 23 cm, AOR 5.3, 95% CI 1.3-22.2), babies of women with positive VDRL serology (AOR 5.1, 95% CI 1.0-25.7), babies of mothers who had previously lost a baby (AOR 1.9, 95% CI 1.1-3.2), and among babies of nulliparous women (AOR 1.7; 95% CI 1.0-3.0). Infections and nutritional deficiencies should be addressed at antenatal clinics.
开展这项研究是为了调查坦桑尼亚北部农村地区围产期死亡率与营养及感染相关因素之间的关联。对3618名到产前诊所就诊的妇女登记了背景信息和产前检查结果,并在分娩后进行随访。确定死产和新生儿死亡情况,并对其近亲进行追踪访谈。7名妇女未获得妊娠结局信息,99名妇女获得的信息不完整。围产期死亡率为27‰活产数[95%置信区间(CI)22‰-33‰];44%为早期新生儿死亡;56%为死产。低出生体重儿(体重2000-2499g的婴儿,调整优势比[AOR]5.8,95%CI 2.1-15.8;体重低于2000g的婴儿AOR 45.7;95%CI 18.3-114.1)、臂围小(低于23cm)的妇女所生婴儿(AOR 5.3,95%CI 1.3-22.2)、VDRL血清学阳性的妇女所生婴儿(AOR 5.1,95%CI 1.0-25.7)、之前有过死胎的母亲所生婴儿(AOR 1.9,95%CI 1.1-3.2)以及初产妇所生婴儿(AOR 1.7;95%CI 1.0-3.0)的围产期死亡风险增加。产前诊所应关注感染和营养缺乏问题。