El-Mahally Azza A, Kharboush Ibrahim F, Amer Naila H, Hussein Mohamed, Abdel Salam Tawfik, Youssef Adel A
Health Administration and Planning and Behavioral Sciences Department, Faculty of Medicine, Alexandria University.
J Egypt Public Health Assoc. 2004;79(3-4):311-31.
Puerperal infections are an important cause of maternal morbidity and mortality in developing nations. Investigators have noted several risk factors for developing puerperal sepsis. However, the relative importance of these risk factors varies and has to be determined for each setting. Therefore the aim of the present work was to determine the risk factors for puerperal sepsis in Alexandria, Egypt. A case-control design was used to study the risk factors of puerperal sepsis in Alexandria. The study included 160 puerperal sepsis cases and 160 controls. Puerperal sepsis cases were recruited from the fever hospital as well as from 3 rural health units and three urban health offices in Alexandria. A pre-designed interviewing questionnaire was used to collect data about risk factors of puerperal sepsis. Logistic regression analysis indicated that very low socio-economic score (OR = 6.4), no ANC (OR = 4.5), delivery at a governmental maternity hospital (OR = 203.4), frequent vaginal examinations (OR = 5.1), anemia during puerperium (OR = 4.3), unsanitary vaginal douching during puerperium (OR = 19.9) and unhygienic preparation of diapers used immediately after delivery (OR = 12.1) were significantly related to the occurrence of puerperal sepsis. Improving infection control measures during delivery, limiting the frequency of vaginal examinations, and avoiding all unhygienic practices related to delivery are strongly recommended.
产褥感染是发展中国家孕产妇发病和死亡的重要原因。研究人员已经指出了几种发生产褥期败血症的风险因素。然而,这些风险因素的相对重要性各不相同,必须针对每种情况加以确定。因此,本研究的目的是确定埃及亚历山大市产褥期败血症的风险因素。采用病例对照设计研究亚历山大市产褥期败血症的风险因素。该研究包括160例产褥期败血症病例和160例对照。产褥期败血症病例是从发热医院以及亚历山大市的3个农村卫生单位和3个城市卫生办公室招募的。使用预先设计的访谈问卷收集有关产褥期败血症风险因素的数据。逻辑回归分析表明,社会经济得分极低(比值比=6.4)、未进行产前检查(比值比=4.5)、在政府妇产医院分娩(比值比=203.4)、频繁的阴道检查(比值比=5.1)、产褥期贫血(比值比=4.3)、产褥期不卫生的阴道灌洗(比值比=19.9)以及分娩后立即使用的尿布准备不卫生(比值比=12.1)与产褥期败血症的发生显著相关。强烈建议在分娩期间改进感染控制措施,限制阴道检查的频率,并避免所有与分娩相关的不卫生做法。