坦桑尼亚农村妇女对产科并发症危险信号的认知
Rural Tanzanian women's awareness of danger signs of obstetric complications.
作者信息
Pembe Andrea B, Urassa David P, Carlstedt Anders, Lindmark Gunilla, Nyström Lennarth, Darj Elisabeth
机构信息
Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P, O, Box 65117, Dar es Salaam, Tanzania.
出版信息
BMC Pregnancy Childbirth. 2009 Mar 26;9:12. doi: 10.1186/1471-2393-9-12.
BACKGROUND
Awareness of the danger signs of obstetric complications is the essential first step in accepting appropriate and timely referral to obstetric and newborn care. The objectives of this study were to assess women's awareness of danger signs of obstetric complications and to identify associated factors in a rural district in Tanzania.
METHODS
A total of 1118 women who had been pregnant in the past two years were interviewed. A list of medically recognized potentially life threatening obstetric signs was obtained from the responses given. Chi-square test was used to determine associations between categorical variables and multivariate logistic regression analysis was used to identify factors associated with awareness of obstetric danger signs.
RESULTS
More than 98% of the women attended antenatal care at least once. Half of the women knew at least one obstetric danger sign. The percentage of women who knew at least one danger sign during pregnancy was 26%, during delivery 23% and after delivery 40%. Few women knew three or more danger signs. According to multivariate logistic regression analysis having secondary education or more increased the likelihood of awareness of obstetric danger signs six-fold (OR = 5.8; 95% CI: 1.8-19) in comparison with no education at all. The likelihood to have more awareness increased significantly by increasing age of the mother, number of deliveries, number of antenatal visits, whether the delivery took place at a health institution and whether the mother was informed of having a risks/complications during antenatal care.
CONCLUSION
Women had low awareness of danger signs of obstetric complications. We recommend the following in order to increase awareness of danger signs of obstetrical complications: to improve quality of counseling and involving other family members in antenatal and postnatal care, to use radio messages and educational sessions targeting the whole community and to intensify provision of formal education as emphasized in the second millennium development goal.
背景
认识产科并发症的危险信号是接受适当及时的产科及新生儿护理转诊的关键第一步。本研究的目的是评估坦桑尼亚一个农村地区妇女对产科并发症危险信号的认识，并确定相关因素。
方法
对过去两年内怀孕的1118名妇女进行了访谈。从她们的回答中获取了一份医学认可的潜在危及生命的产科症状清单。采用卡方检验确定分类变量之间的关联，并使用多因素逻辑回归分析来确定与产科危险信号认识相关的因素。
结果
超过98%的妇女至少参加过一次产前检查。一半的妇女至少知道一种产科危险信号。在孕期知道至少一种危险信号的妇女比例为26%，分娩时为23%，产后为40%。很少有妇女知道三种或更多危险信号。根据多因素逻辑回归分析，与未接受任何教育相比，接受过中等及以上教育的妇女认识产科危险信号的可能性增加了六倍（比值比=5.8；95%置信区间：1.8-19）。母亲年龄增加（35岁及以上）、分娩次数、产前检查次数增加、分娩是否在医疗机构进行以及母亲在产前检查时是否被告知有风险/并发症，认识更多危险信号的可能性显著增加。
结论
妇女对产科并发症危险信号的认识较低。为了提高对产科并发症危险信号的认识，我们建议：提高咨询质量并让其他家庭成员参与产前和产后护理；利用针对整个社区的广播信息和教育课程；按照千年发展目标的要求，加强正规教育的提供。
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