Osei Eric, Agbemefle Isaac, Kye-Duodu Gideon, Binka Fred Newton
Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana.
School of Public Health, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana.
BMC Pregnancy Childbirth. 2016 Mar 4;16:48. doi: 10.1186/s12884-016-0835-x.
Seasonal variations greatly influence birth patterns differently from country to country. In Ghana, there is paucity of information on birth seasonal patterns. This retrospective study described the trends and seasonality of births and perinatal outcomes in Upper East Region of Ghana.
Births occurring in each month of the calendar years (2010-2014; inclusive) were extracted from the District Health Information Management System (DHIMS2) database of the Bolgatanga Municipal Health Directorate and exported into Microsoft Excel spread sheet and Epi Ifo for analysis. Analysis was carried out by calculating average number of births per month correcting for unequal month length using 30 days. A Chi-square test for trend was performed to check for statistical significance (p < 0.05) in trends and seasonality of birth and perinatal outcomes.
There were 24,171 health facility deliveries, of which 97.7% were singleton deliveries and 2.3% were multiple (two or three) deliveries. There was a consistent rise in the annual health facility deliveries controlled for the number of fertile women, from 4169 in 2010 to 5474 in 2014 (p < 0.0001). Monthly birth distribution displayed a periodic pattern with peaks in May, September and October and troughs during the months of January, February and July (p < 0.0001). Women were likely to give birth during the raining season than the dry season. Caesarean Section (CS) rate showed a steady rise over the years (124 per 1000 births in 2010 to 185 per 1000 births in 2014 (p < 0.0001) with overall rate of 14.6%. Stillbirth (SB) rate, however decreased slightly over the years from 29 per 1000 births to 23 per 1000 births (p = 0.197) with overall SB rate of 2.6%. Similarly, Low Birth Weight (LBW) declined from 77 per 1000 live births to 71 per 1000 live births from 2010 to 2014 (p < 0.0001). Seasonal (rainy and dry) distributions did not show a clear difference in birth frequencies.
Health facility delivery was persistently high in the Bolgatanga Municipality with birth peaking in May, September and October. Despite the rising rate of caesarean section, stillbirth rate did not significantly improved over the years. A prospective study may reveal the reasons for the increasing caesarean section rate. Additionally, understanding the factors that affect the decreasing trends of low birth weight in the municipality is crucial to public health policy makers in Ghana.
季节变化对不同国家的出生模式有很大影响。在加纳，关于出生季节模式的信息匮乏。这项回顾性研究描述了加纳上东部地区的出生趋势和季节性以及围产期结局。
从博尔加坦加市卫生局的地区卫生信息管理系统（DHIMS2）数据库中提取2010年至2014年（含）历年各月的出生记录，并导出到Microsoft Excel电子表格和Epi Info中进行分析。通过使用30天校正不等月长来计算每月平均出生数进行分析。进行趋势卡方检验以检查出生和围产期结局的趋势及季节性的统计学显著性（p < 0.05）。
共有24,171例在医疗机构分娩，其中97.7%为单胎分娩，2.3%为多胎（双胎或三胎）分娩。在控制了育龄妇女数量后，年度医疗机构分娩量持续上升，从2010年的4169例增至2014年的5474例（p < 0.0001）。每月出生分布呈现周期性模式，5月、9月和10月为高峰，1月、2月和7月为低谷（p < 0.0001）。与旱季相比，妇女在雨季分娩的可能性更大。剖宫产率多年来呈稳步上升趋势（从2010年的每1000例分娩124例升至2014年的每1000例分娩185例（p < 0.0001），总体剖宫产率为14.6%）。然而，死胎率多年来略有下降，从每1000例分娩29例降至每1000例分娩23例（p = 0.197），总体死胎率为2.6%。同样，低体重儿发生率从2010年至2014年从每1000例活产77例降至每1000例活产71例（p < 0.0001）。季节性（雨季和旱季）分布在出生频率上未显示出明显差异。
博尔加坦加市医疗机构分娩率一直很高，5月、9月和10月出生人数达到高峰。尽管剖宫产率上升，但多年来死胎率并未显著改善。前瞻性研究可能会揭示剖宫产率上升的原因。此外，了解影响该市低体重儿发生率下降趋势的因素对加纳的公共卫生政策制定者至关重要。
