健康寻求行为对尼日利亚脐带脱垂发生率和围生结局的影响。

The influence of health-seeking behavior on the incidence and perinatal outcome of umbilical cord prolapse in Nigeria.

机构信息

SUNY Downstate Medical Center, Brooklyn, New York, USA;

出版信息

Int J Womens Health. 2010 Aug 9;2:177-82. doi: 10.2147/ijwh.s11078.

DOI:10.2147/ijwh.s11078

PMID:21072310

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2971738/

Abstract

OBJECTIVES

To determine the influence of health-seeking behavior of urban women in South-West Nigeria on the incidence and perinatal outcome of umbilical cord prolapse (UCP).

METHODS

A retrospective study comparing two groups of urban women using information extracted from medical records of patients who had UCP, and were managed at the University College Hospital Ibadan, Nigeria from January1st 1995 to December 31st 2005. The data was analyzed using SPSS software (version 15). Analysis included simple tabulation, proportion and comparison of incidence, perinatal morbidity, and mortality of UCP between the two groups of women using Chi-square or Fisher's exact test. Odds ratio (OR) and 95% confidence intervals (CI) were calculated whenever necessary. P-value of 0.05 or less was statistically significant.

RESULTS

Women without prenatal care were more likely to have fetuses with UCP (54, 75%), than in women who had prenatal care (18, 25%). The risk of perinatal death from UCP was higher in women without prenatal care, as compared with those who received prenatal care (OR 3.02, 95% CI: 0.879 to 10.356; P-value = 0.061). The risk of perinatal morbidity and neonatal intensive care admission was also higher among women without prenatal care as compared with women who received prenatal care (OR 4.09, 95% CI: 1.03 to 16.30; P-value = 0.041). The overall perinatal mortality rate in the study population was 403 per 1000 total births, and this was five times more than that of the hospital perinatal mortality rate of 80 per 1000 total births during the study period. The perinatal mortality rate was higher among women without prenatal care, 463 per 1000 total births, as compared with 222 per 1000 total births in women who received prenatal care. Perinatal death before arrival at the hospital is less likely to occur in women with prenatal care when compared with women without prenatal care (OR 0.0635; 95% CI: 0.0052 to 0.776; P-value = 0.03).

CONCLUSION

A high index of suspicion and an identification of risk factors, with early diagnosis, prompt intervention, and provision of health care facilities can reduce the incidence and poor outcome of UCP in developing countries.

摘要

目的

探讨尼日利亚西南部城市妇女的就医行为对脐带脱垂（UCP）发生率和围产结局的影响。

方法

采用回顾性研究比较了两组城市妇女的资料，这些妇女的信息均来自于在尼日利亚伊巴丹大学教学医院就诊并于 1995 年 1 月 1 日至 2005 年 12 月 31 日期间诊断为 UCP 的患者的病历。数据使用 SPSS 软件（版本 15）进行分析。分析包括简单制表、比例和比较两组妇女 UCP 的发生率、围产发病率和死亡率，使用卡方检验或 Fisher 确切概率法进行比较。必要时计算比值比（OR）和 95%置信区间（CI）。P 值小于或等于 0.05 具有统计学意义。

结果

无产前保健的妇女的胎儿发生 UCP 的可能性高于有产前保健的妇女（54 例[75%]比 18 例[25%]）。与接受产前保健的妇女相比，无产前保健的妇女的 UCP 围产儿死亡风险更高（OR 3.02，95%CI：0.879 至 10.356；P 值=0.061）。与接受产前保健的妇女相比，无产前保健的妇女的围产发病率和新生儿重症监护病房入院率也更高（OR 4.09，95%CI：1.03 至 16.30；P 值=0.041）。研究人群的总围产儿死亡率为每 1000 例活产 403 例，是研究期间医院每 1000 例活产 80 例的 5 倍。与接受产前保健的妇女每 1000 例活产 222 例相比，无产前保健的妇女的围产儿死亡率更高，每 1000 例活产 463 例。与无产前保健的妇女相比，有产前保健的妇女在到达医院之前发生围产儿死亡的可能性较小（OR 0.0635；95%CI：0.0052 至 0.776；P 值=0.03）。