Centre for Medical Parasitology, Institute of International Health, Immunology, and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Øster Farimagsgade 5, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2012 Sep;91(9):1061-8. doi: 10.1111/j.1600-0412.2012.01478.x.
To identify factors associated with perinatal mortality in northeastern Tanzania.
Prospective cohort study.
Northeastern Tanzania. Population. 872 mothers and their newborns.
Pregnant women were screened for factors possibly associated with perinatal mortality, including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated.
Perinatal mortality.
Forty-six deaths occurred. Key factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining deaths, 27% (7/26) were attributed to preeclampsia and 23% (6/26) to small-for-gestational age. Of these, 54% (14/26) were preterm.
Preeclampsia, small-for-gestational age and preterm delivery were key risk factors and causes of perinatal mortality in this area of Tanzania. Maternal anemia was also strongly associated with perinatal mortality. Furthermore, asphyxia accounted for a large proportion of the perinatal deaths. Interventions should target the prevention and handling of these conditions in order to reduce perinatal mortality.
确定坦桑尼亚东北部围产期死亡的相关因素。
前瞻性队列研究。
坦桑尼亚东北部。人群：872 名孕妇及其新生儿。
对孕妇进行筛查，以确定可能与围产期死亡相关的因素，包括子痫前期、小于胎龄儿、早产、贫血和寻求医疗行为。使用超声监测胎儿生长情况。最后，评估围产期死亡的具体原因。
围产期死亡率。
共发生 46 例死亡。与围产期死亡相关的关键因素是早产（调整后的优势比（OR）14.47，95%置信区间（CI）3.23-64.86，p <0.001）、小于胎龄儿（调整后的 OR 3.54，95%CI 1.18-10.61，p=0.02）和产妇贫血（调整后的 OR 10.34，95%CI 1.89-56.52，p=0.007）。遵循产前保健计划（调整后的 OR 0.027，95%CI 0.003-0.26，p=0.002）可预防围产期死亡。43%（43/100）病例的死亡原因归因于与分娩相关的并发症，特别是产程窒息（30%）和新生儿感染（13%）。在其余死亡中，27%（7/26）归因于子痫前期，23%（6/26）归因于小于胎龄儿。其中，54%（14/26）为早产。
在坦桑尼亚东北部，子痫前期、小于胎龄儿和早产是围产期死亡的关键危险因素和原因。产妇贫血也与围产期死亡密切相关。此外，窒息占围产期死亡的很大比例。干预措施应针对这些情况的预防和处理，以降低围产期死亡率。
