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喀麦隆一家城市医疗机构中出生窒息的风险因素。

Risk factors for birth asphyxia in an urban health facility in cameroon.

作者信息

Chiabi Andreas, Nguefack Seraphin, Mah Evelyne, Nodem Sostenne, Mbuagbaw Lawrence, Mbonda Elie, Tchokoteu Pierre-Fernand, Doh Frcog Anderson

机构信息

Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon.

Université des Montagnes, Banganté, Cameroun.

出版信息

Iran J Child Neurol. 2013 Summer;7(3):46-54.

Abstract

OBJECTIVE

The World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates.

MATERIALS & METHODS: This study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors.

RESULTS

The prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour, prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% had a satisfactory outcome.

CONCLUSION

The incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal visits through informing and communicating with pregnant women should be reinforced.

摘要

目的

世界卫生组织(WHO)估计,每年有400万儿童出生时窒息,其中100万死亡,另有100万存活但伴有严重神经后遗症。本研究的目的是确定出生窒息的危险因素以及受影响新生儿的医院结局。

材料与方法

本研究是在雅温得一家三级医院对足月新生儿进行的前瞻性病例对照研究,将第5分钟时阿氏评分<7分的新生儿作为病例组,并与第5分钟时阿氏评分≥7分的新生儿作为对照组进行匹配。对母亲和新生儿的相关变量进行统计分析,以确定显著的危险因素。

结果

新生儿窒息的患病率为每1000例活产80.5例。具有统计学意义的危险因素包括单身婚姻状况、产前检查地点、疟疾、先兆子痫/子痫、产程延长、产程停滞、胎膜早破时间延长和胎位异常。医院死亡率为6.7%,出院时12.2%的患儿有神经功能缺损和/或经囟门超声/脑电图异常,81.1%的患儿结局良好。

结论

本研究中出生窒息的发生率为每1000例活产80.5%,死亡率为6.7%。产前危险因素包括:产前检查地点、孕期疟疾和先兆子痫/子痫。而产程延长、产程停滞和足月胎膜早破时间延长是产时危险因素。应加强产前检查期间通过向孕妇提供信息和沟通进行的预防措施。

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WHO estimates of the causes of death in children.世界卫生组织对儿童死因的估计。
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