Santosh Asha, Zunjarwad Geeta, Hamdi Ilham, Al-Nabhani Jamila A, Sherkawy Bahaa E, Al-Busaidi Ibrahim H
Departments of Obstetrics & Gynecology, Nizwa Hospital, Oman.
Sultan Qaboos Univ Med J. 2013 Nov;13(4):545-50. doi: 10.12816/0003314. Epub 2013 Nov 8.
This study aimed to provide insight into the causes of stillbirths and early neonatal deaths and identify better intervention strategies.
This was a retrospective study during a 7-year period (January 2003 to December 2009) of all stillbirths and early neonatal deaths at the Nizwa regional referral hospital in Al-Dakhiliyah region, Oman.
Of a total 27,668 births, there were 244 stillbirths and 157 early neonatal deaths. The perinatal mortality rate (PMR) was 14.49/1,000 births. The period-specific rates were 17.23/1,000 in 2003, 18.33/1,000 in 2004, 15.20/1,000 in 2005, 12.20/1,000 in 2006, 12.46/1,000 in 2007 and 12.09/1000 in 2008. This decline in the death rate was significant (P = <0.005). The rate rose in 2009 to 15.63/1,000, mostly from an increase in early neonatal deaths (congenital anomalies). The most common identifiable cause of stillbirth was congenital anomalies (18.82%), in which central nervous system anomalies were most common. Other causes include abruptio placentae (13%), cord accidents (12%), and intrauterine growth restriction (IUGR), while the cause remained unknown in 22.59%. Congenital anomalies accounted for 53.50% of early neonatal deaths followed by prematurity (23.56%) and birth asphyxia (5.73%). Extremes of maternal age were related to higher PMRs.
An overall improvement in the stillbirths and neonatal death rates was witnessed; however, further improvement is warranted for common avoidable fetal and maternal risk factors. Extra care needs to be provided for women who are at risk of developing complications such as gestational diabetes, pregnancy-induced hypertension, IUGR, etc.
本研究旨在深入了解死产和早期新生儿死亡的原因，并确定更好的干预策略。
这是一项回顾性研究，研究对象为阿曼达希利亚地区尼兹瓦地区转诊医院在2003年1月至2009年12月这7年期间的所有死产和早期新生儿死亡病例。
在总共27668例分娩中，有244例死产和157例早期新生儿死亡。围产儿死亡率（PMR）为14.49/1000例分娩。各时期的死亡率分别为：2003年17.23/1000，2004年18.33/1000，2005年15.20/1000，2006年12.20/1000，2007年12.46/1000，2008年12.09/1000。死亡率的下降具有显著性（P = <0.005）。2009年死亡率上升至15.63/1000，主要是由于早期新生儿死亡（先天性异常）增加。死产最常见的可识别原因是先天性异常（18.82%），其中中枢神经系统异常最为常见。其他原因包括胎盘早剥（13%）、脐带意外（12%）和宫内生长受限（IUGR），而22.59%的病例原因不明。先天性异常占早期新生儿死亡的53.50%，其次是早产（23.56%）和出生窒息（5.73%）。产妇年龄 extremes与较高的围产儿死亡率相关。
死产和新生儿死亡率总体有所改善；然而，对于常见的可避免的胎儿和产妇风险因素，仍需进一步改善。对于有发生妊娠糖尿病、妊娠高血压、宫内生长受限等并发症风险的妇女，需要给予额外的护理。
