Hassan Mona H A, Ahmed Magda R, Shehata Shehata F, Sadek Sameh S E
aDepartment of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of SaudiArabia bDepartment of Biostatistics, High Institute of Public Health cDepartment of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Egypt Public Health Assoc. 2012 Aug;87(3-4):51-6. doi: 10.1097/01.EPX.0000417960.79703.06.
Egypt has already achieved the goal of reducing the under-five mortality rate (U5MR) by two-thirds. However, one of the challenges that Egypt currently faces is how to reduce the perinatal and neonatal mortality (PM, NM). This study aimed to identify the social and biomedical risk factors contributing toward PM and NM in Alexandria, Egypt.
A case-control design was used. Cases were 150 mothers whose index pregnancy terminated in perinatal (from the 28th week of pregnancy to less than 7 days after birth) and neonatal deaths (from the seventh day to less than the 28th day after birth). They were selected from the antenatal clinic and neonatal care unit of ElShatby University hospital for Obstetrics and gynecology. Controls were 150 mothers with live births ranging in age from 28 days up to 2 months selected from the outpatient clinics of ElShatby University Hospital for Pediatrics.
Stepwise logistic regression analysis indicated a higher risk of PM/NM among very young or very old mothers (OR=4.1 and 6.46, respectively), those who had previous PM/NM [odds ratio (OR)=12.7; 95% confidence interval (CI): 5.04-29.54], grand multiparous (OR=2.23; 95% CI: 1.50-5.42), those with infrequent antenatal visits (OR=3.88; 95% CI: 2.26-6.65), and mothers with complications during the index pregnancy (OR=9.21; 95% CI: 3.40-24.95).
This study confirms the evidence of a positive association between PM/NM and maternal age, obstetric history, and utilization of healthcare services. Appropriate age at marriage and pregnancy, spacing of and limiting the number of births, and improving antenatal, natal, and postnatal care are priority actions that can reduce PM/NM in Alexandria.
埃及已经实现了将五岁以下儿童死亡率降低三分之二的目标。然而，埃及目前面临的挑战之一是如何降低围产期和新生儿死亡率（PM，NM）。本研究旨在确定导致埃及亚历山大市围产期和新生儿死亡的社会和生物医学风险因素。
采用病例对照设计。病例为150名母亲，其索引妊娠以围产期（从妊娠第28周起至出生后不到7天）和新生儿死亡（从出生后第7天至不到第28天）告终。她们是从艾尔沙比大学妇产科医院的产前诊所和新生儿护理病房选取的。对照为150名有活产婴儿的母亲，年龄在28天至2个月之间，是从艾尔沙比大学儿科医院的门诊选取的。
逐步逻辑回归分析表明，非常年轻或非常年长的母亲发生围产期/新生儿死亡的风险较高（比值比分别为4.1和6.46），有过围产期/新生儿死亡经历的母亲（比值比（OR）=12.7；95%置信区间（CI）：5.04 - 29.54），多产次母亲（OR = 2.23；95% CI：1.50 - 5.42），产前检查次数少的母亲（OR = 3.88；95% CI：2.26 - 6.65），以及索引妊娠期间有并发症的母亲（OR = 9.21；95% CI：3.40 - 24.95）。
本研究证实了围产期/新生儿死亡与母亲年龄、产科病史及医疗服务利用之间存在正相关的证据。适当的结婚和怀孕年龄、生育间隔和限制生育数量，以及改善产前、产时和产后护理是可降低亚历山大市围产期/新生儿死亡的优先行动。
