Darmstadt Gary L, Hassan Mohamed, Balsara Zohra P, Winch Peter J, Gipson Reginald, Santosham Mathuram
International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA.
J Health Popul Nutr. 2009 Dec;27(6):746-54. doi: 10.3329/jhpn.v27i6.4326.
This cross-sectional cohort study explored the impact of the use of clean delivery-kit (CDK) on morbidity due to newborn umbilical cord and maternal puerperal infections. Kits were distributed from primary-care facilities, and birth attendants received training on kit-use. A nurse visited 334 women during the first week postpartum to administer a structured questionnaire and conduct a physical examination of the neonate and the mother. Results of bivariate analysis showed that neonates of mothers who used a CDK were less likely to develop cord infection (p = 0.025), and mothers who used a CDK were less likely to develop puerperal sepsis (p = 0.024). Results of multiple logistic regression analysis showed an independent association between decreased cord infection and kit-use [odds ratio (OR) = 0.42, 95% confidence interval (CI) 0.18-0.97, p = 0.041)]. Mothers who used a CDK also had considerably lower rates of puerperal infection (OR = 0.11, 95% CI 0.01-1.06), although the statistical strength of the association was of borderline significance (p = 0.057). The use of CDK was associated with reductions in umbilical cord and puerperal infections.
这项横断面队列研究探讨了使用清洁分娩包（CDK）对新生儿脐带感染和产妇产褥期感染发病率的影响。分娩包由基层医疗设施发放，助产人员接受了关于分娩包使用的培训。一名护士在产后第一周走访了334名妇女，发放结构化问卷并对新生儿和母亲进行体格检查。双变量分析结果显示，使用CDK的母亲所生新生儿发生脐带感染的可能性较小（p = 0.025），使用CDK的母亲发生产褥期败血症的可能性较小（p = 0.024）。多元逻辑回归分析结果显示，脐带感染减少与使用分娩包之间存在独立关联[比值比（OR）= 0.42，95%置信区间（CI）0.18 - 0.97，p = 0.041]。使用CDK的母亲产褥期感染率也显著较低（OR = 0.11，95% CI 0.01 - 1.06），尽管这种关联的统计学强度处于临界显著水平（p = 0.057）。使用CDK与脐带感染和产褥期感染的减少有关。
