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一个快速发展国家的阿拉伯女性的孕产妇并发症及新生儿结局

Maternal complications and neonatal outcome in Arab women of a fast developing country.

作者信息

Bener Abdulbari, Al-Nufal Mohammed, Vachhani Pankit J, Ali Awab I, Samson Nancy, Saleh Najah M

机构信息

Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Qatar ; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK ; Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar.

出版信息

J Family Community Med. 2013 Jan;20(1):27-34. doi: 10.4103/2230-8229.108181.

Abstract

OBJECTIVE

The objective of the study was to examine maternal complications that occur during the third trimester and their neonatal outcome in Arab women residing in Qatar.

DESIGN

This is a prospective hospital-based study.

SETTING

The survey was carried out in women's hospital.

MATERIALS AND METHODS

The study was based on the log book of the women's hospital, from which we recruited women in their third trimester of pregnancy between the first week of January 2010 and April 2011. Of the 1 824 Arab women who were approached to participate in the study, 1 432 (78.5%) consented. Face-to-face interviews were conducted with the pregnant women in the third trimester attending routine antenatal clinics at a women's hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Medical records of the patients were referred to collect the clinical variables.

RESULTS

Of the pregnant women studied, 39.8% were less than 30 years of age. The risk of maternal complications was higher in housewives (60.8%) and women with a low monthly household income (38.2%). Most of the pregnant women (77.6%) had antenatal care. Normal delivery (69.7%) was more common in expatriate Arab women, whereas caesarean was more prevalent in Qatari women (22.2%). Women aged 35 years or older had a significantly higher risk of maternal complications such as gestational diabetes (20.8% vs 13.4%; P < 0.01), gestational hypertension (21.6% vs 15.2%; P = 0.003), and ante-partum hemorrhage (17.9% vs 13.7%; P = 0.042) than younger women. Gestational diabetes increased the risk of caesarean delivery (25.1%) and macrosomia (42.3%). The frequency of caesarean delivery (22.1%) was higher in women with gestational hypertension. Neonatal complications such as Apgar score (<7) 1 minute (33.1% vs 21.2%; P < 0.001), 5 minutes (13.1% vs 8.2%; P = 0.005), and congenital anomalies (2.9% vs 0.9%; P = 0.007) were significantly higher in newborns of older women. Low birth weight (11.1%) and Apgar 1(st) minute < 7 rate (28.2%) were higher in newborns of mothers with ante-partum hemorrhage.

CONCLUSION

The study findings revealed that maternal complications such as gestational diabetes, gestational hypertension, ante-partum hemorrhage, and maternal anemia were significantly higher in older pregnant women. Similarly, neonatal complications were higher in the newborns of older women. Gestational hypertension was the leading maternal complication observed in Arab women.

摘要

目的

本研究的目的是调查卡塔尔阿拉伯女性在孕晚期出现的孕产妇并发症及其新生儿结局。

设计

这是一项基于医院的前瞻性研究。

地点

调查在一家妇女医院进行。

材料与方法

本研究基于妇女医院的日志,我们从中招募了2010年1月第一周至2011年4月期间处于妊娠晚期的妇女。在被邀请参与研究的1824名阿拉伯女性中,1432名(78.5%)同意参与。对在妇女医院常规产前诊所就诊的妊娠晚期孕妇进行面对面访谈。问卷涵盖了与社会人口学因素、家族史、病史、孕产妇并发症和新生儿结局相关的变量。查阅患者的病历以收集临床变量。

结果

在研究的孕妇中,39.8%年龄小于30岁。家庭主妇(60.8%)和家庭月收入低的女性(38.2%)发生孕产妇并发症的风险更高。大多数孕妇(77.6%)接受了产前护理。正常分娩(69.7%)在外籍阿拉伯女性中更为常见,而剖宫产在卡塔尔女性中更为普遍(22.2%)。35岁及以上的女性发生孕产妇并发症如妊娠期糖尿病(20.8%对13.4%;P<0.01)、妊娠期高血压(21.6%对15.2%;P = 0.003)和产前出血(17.9%对13.7%;P = 0.042)的风险明显高于年轻女性。妊娠期糖尿病增加了剖宫产(25.1%)和巨大儿(42.3%)的风险。妊娠期高血压女性的剖宫产率(22.1%)更高。老年女性新生儿的新生儿并发症如1分钟阿氏评分(<7)(33.1%对21.2%;P<0.001)、5分钟(13.1%对8.2%;P = 0.005)和先天性异常(2.9%对0.9%;P = 0.007)明显更高。产前出血母亲的新生儿低出生体重(11.1%)和1分钟阿氏评分<7率(28.2%)更高。

结论

研究结果显示,老年孕妇的妊娠期糖尿病、妊娠期高血压、产前出血和孕产妇贫血等孕产妇并发症明显更高。同样,老年女性新生儿的新生儿并发症也更高。妊娠期高血压是在阿拉伯女性中观察到的主要孕产妇并发症。

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