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[巴西北部一家公立医院胎膜破裂情况下妊娠的围产期发病率和死亡率]

[Perinatal morbidity and mortality in pregnancies that progressed with ruptured membranes at a public hospital in Northern Brazil].

作者信息

da Silva Samara Maria Messias, Mattos Luma Caroline Gomes, de Macedo Lucas Felipe, de Araújo Thiago Santos

机构信息

Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Rio Branco, AC, Brasil.

Universidade Federal do Acre, Rio Branco, AC, Brasil.

出版信息

Rev Bras Ginecol Obstet. 2014 Oct;36(10):442-8. doi: 10.1590/so100-720320140004941.

Abstract

PURPOSE

To identify obstetric and perinatal factors associated with perinatal morbidity and mortality in pregnancies that progressed with ruptured membranes.

METHODS

A cross-sectional hospital-based study with secondary data from records of patients (n=87) that evolved with the premature rupture of membranes between 24 and 42 weeks of gestation, admitted from January to April 2013 to a public hospital in Acre State, North of Brazil. Data were subjected to bivariate analysis for selection of variables to be used in a multiple regression model according to Poisson logistic regression with robust error.

RESULTS

The prevalence of perinatal morbidity-mortality was 51.4%, including a 2.3% death rate (2 cases) and a 9.2% fetal neonatal death rate (8 cases). The variables associated with mortality in the final multiple model were: number of prenatal consultations ≥6, with a prevalence ratio (PR) of 0.5 and a 95% confidence interval (95%CI) of 0.3-0.9, gestational age ≥30 weeks (PR=0.6; 95%CI 0.4-0.8), low birth weight (PR=2.9; 95%CI 1.5-5.4), and mechanical ventilation (PR=3.8; 95%CI 2.0-7.2).

CONCLUSION

Perinatal morbidity and mortality were high among cases of ruptured membranes. Morbidity and mortality were associated with factors such as fewer prenatal visits, extreme prematurity and low birth weight in this group.

摘要

目的

确定胎膜破裂妊娠中与围产期发病率和死亡率相关的产科及围产期因素。

方法

一项基于医院的横断面研究,使用2013年1月至4月间入住巴西北部阿克里州一家公立医院的87例患者记录中的二手数据,这些患者在妊娠24至42周时发生胎膜早破。根据具有稳健误差的泊松逻辑回归对数据进行双变量分析,以选择用于多元回归模型的变量。

结果

围产期发病死亡率为51.4%,包括2.3%的死亡率(2例)和9.2%的胎儿新生儿死亡率(8例)。最终多元模型中与死亡率相关的变量为:产前检查次数≥6次,患病率比(PR)为0.5,95%置信区间(95%CI)为0.3 - 0.9;孕周≥30周(PR = 0.6;95%CI 0.4 - 0.8);低出生体重(PR = 2.9;95%CI 1.5 - 5.4);以及机械通气(PR = 3.8;95%CI 2.0 - 7.2)。

结论

胎膜破裂病例的围产期发病率和死亡率较高。该组中的发病率和死亡率与产前检查次数较少、极早产和低出生体重等因素相关。

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