中非农村地区的死产和早期新生儿死亡率
Stillbirth and early neonatal mortality in rural Central Africa.
作者信息
Engmann Cyril, Matendo Richard, Kinoshita Rinko, Ditekemena John, Moore Janet, Goldenberg Robert L, Tshefu Antoinette, Carlo Waldemar A, McClure Elizabeth M, Bose Carl, Wright Linda L
机构信息
University of North Carolina at Chapel Hill, North Carolina 27599-7596, USA.
出版信息
Int J Gynaecol Obstet. 2009 May;105(2):112-7. doi: 10.1016/j.ijgo.2008.12.012. Epub 2009 Feb 7.
OBJECTIVE
To develop a prospective perinatal registry that characterizes all deliveries, differentiates between stillbirths and early neonatal deaths (ENDs), and determines the ratio of fresh to macerated stillbirths in the northwest Democratic Republic of Congo.
METHOD
Birth outcomes were obtained from 4 rural health districts.
RESULTS
A total of 8230 women consented, END rate was 32 deaths per 1000 live births, and stillbirth rate was 33 deaths per 1000 deliveries. The majority (75%) of ENDs and stillbirths occurred in neonates weighing 1500 g or more. Odds of stillbirth and END increased in mothers who were single or who did not receive prenatal care, and among premature, low birth weight, or male infants. The ratio of fresh to macerated stillbirths was 4:1.
CONCLUSION
Neonates weighing 1500 g or more at birth represent a group with a high likelihood of survival in remote areas, making them potentially amenable to targeted intervention packages. The ratio of fresh to macerated stillbirths was approximately 10-fold higher than expected, suggesting a more prominent role for improved intrapartum obstetric interventions.
目的
建立一个前瞻性围产期登记系统，对所有分娩情况进行特征描述，区分死产和早期新生儿死亡（END），并确定刚果民主共和国西北部新鲜死产与浸软死产的比例。
方法
从4个农村卫生区获取出生结局数据。
结果
共有8230名妇女同意参与，END发生率为每1000例活产中有32例死亡，死产率为每1000例分娩中有33例死亡。大多数（75%）的END和死产发生在体重1500克或以上的新生儿中。单身或未接受产前护理的母亲，以及早产、低体重或男婴发生死产和END的几率增加。新鲜死产与浸软死产的比例为4:1。
结论
出生时体重1500克或以上的新生儿在偏远地区是存活可能性较高的群体，因此可能适合接受有针对性的干预措施。新鲜死产与浸软死产的比例比预期高出约10倍，这表明改善产时产科干预措施的作用更为突出。
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