Feresu Shingairai A, Harlow Siobán D, Welch Kathy, Gillespie Brenda W
Department of Epidemiology, School of Public Health, University of Michigan, MI 48105, USA.
Paediatr Perinat Epidemiol. 2004 Mar;18(2):154-63. doi: 10.1111/j.1365-3016.2003.00539.x.
Data on birth outcomes are important for planning maternal and child health care services in developing countries. Only a few studies have examined frequency of birth outcomes in Zimbabwe, none of which has jointly examined the spectrum of poor birth outcomes across important demographic subgroups. We assessed delivery patterns and birth outcomes in 17 174 births over a one-year period from October 1997 to September 1998 at Harare Hospital, Zimbabwe. The annual rate of stillbirth was 61 per 1000 live births, rate of preterm birth (<37 weeks) was 168 per 1000, and low birthweight (LBW) (<2500 g) was 199 per 1000. Not attending antenatal care (prenatal care) was associated with increased risks of stillbirth [relative risk (RR) = 2.54, 95% CI 2.21, 2.92], preterm delivery [RR = 2.43, 95% CI 2.26, 2.61] and LBW births [RR = 2.16, 95% CI 2.02, 2.31]. Preterm births and LBW births were more likely to be stillborn [RR = 7.26, 95% CI 6.28, 8.39 and RR = 6.85, 95% CI 5.94, 7.91]. In conclusion, the rate of stillbirth is high and is predominantly associated with preterm births and to a lesser extent LBW. Reducing the frequency of stillbirth will require a better understanding of the determinants of preterm births and strategies for addressing this particular subset of high-risk births.
出生结局数据对于发展中国家规划母婴保健服务至关重要。仅有少数研究调查了津巴布韦的出生结局频率,其中没有一项研究联合考察过重要人口亚组中不良出生结局的范围。我们评估了1997年10月至1998年9月这一年期间在津巴布韦哈拉雷医院出生的17174例分娩的分娩模式和出生结局。死产的年发生率为每1000例活产61例,早产(<37周)率为每1000例168例,低出生体重(LBW)(<2500 g)率为每1000例199例。未接受产前护理与死产风险增加相关[相对风险(RR)=2.54,95%置信区间2.21,2.92]、早产[RR = 2.43,95%置信区间2.26,2.61]和低出生体重儿出生[RR = 2.16,95%置信区间2.02,2.31]。早产和低出生体重儿更有可能成为死产儿[RR = 7.26,95%置信区间6.28,8.39和RR = 6.85,95%置信区间5.94,7.91]。总之,死产率很高,主要与早产相关,在较小程度上与低出生体重有关。降低死产频率将需要更好地了解早产的决定因素以及应对这一特定高危出生子集的策略。