在埃塞俄比亚亚的斯亚贝巴选定公立医院就诊的产妇中,子痫前期/子痫的发生决定因素:病例对照研究。
Determinants of pre-eclampsia/Eclampsia among women attending delivery Services in Selected Public Hospitals of Addis Ababa, Ethiopia: a case control study.
机构信息
School of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2017 Sep 15;17(1):307. doi: 10.1186/s12884-017-1507-1.
BACKGROUND
Pre-eclampsia is a pregnancy-specific hypertensive disorder usually occurs after 20 weeks of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In Ethiopia, the major direct obstetric complications including pre-eclampsia/eclampsia account for 85% of the maternal deaths. Unlike deaths due to other direct causes, pre-eclampsia/ eclampsia related deaths appear to be increasing and linked to multiple factors, making prevention of the disease a continuous challenge. The aim of this study is to assess determinants of pre-eclampsia/eclampsiaamong women attending delivery services in selected public hospitals in Addis Ababa, Ethiopia.
METHODS
Hospital based unmatched case control study design was employed. The study wasconducted in Addis Ababa among women attending delivery services in two public hospitals from December, 2015 G.C. to February, 2016 G.C. with sample size of 291 (97 cases and 194 controls). Women with pre-eclampsia/eclampsia were cases and women who had not diagnosed for pre-eclampsia/eclampsia were controls. Case-control incidence density sampling followed by interviewer administered was conducted using pretested questionnaire. The data was entered in Epi Info 7 software and exported to STATA 14 for cleaning and analysis. Descriptive statistics were used todisplay the data using tables compared between cases and controls. To compare categorical variables between cases and controls Chi-squared testwas used. Both bivariable and multivariable logistic regression analyses were computed to identify the determinants of pre-eclampsia/eclampsia.
RESULTS
Factors that were found to have statistically significant association with pre-eclampsia or eclampsia were primigravida (AOR: 2.68, 95% CI: 1.38, 5.22), history of preeclampsia on prior pregnancy (AOR: 4.28, 95% CI: 1.61, 11.43), multiple pregnancy (AOR: 8.22, 95% CI: 2.97, 22.78), receiving nutritional counseling during pregnancy (AOR: 0.22, 95% CI: 0.1, 0.48) and drinking alcohol during pregnancy (AOR: 3.97, 95% CI: 1.8, 8.75).
CONCLUSIONS
The study identified protective and risk factors for pre-eclampsia/eclampsia. To promptly diagnose and treat pre-eclampsia, health workers should give special attention to women with primigravida and multiple pregnancy. Besides, health care providers should provide nutritional counseling during ANC, including avoiding drinking alcohol during their pregnancy.
背景
子痫前期是一种妊娠特有的高血压疾病,通常发生在妊娠 20 周后。它是全球孕产妇和围产儿发病率和死亡率的主要原因之一。在埃塞俄比亚,主要的直接产科并发症,包括子痫前期/子痫,占孕产妇死亡的 85%。与其他直接原因导致的死亡不同,子痫前期/子痫相关的死亡似乎在增加,并与多种因素有关,这使得预防这种疾病成为一个持续的挑战。本研究旨在评估在埃塞俄比亚亚的斯亚贝巴选定的公立医院分娩服务的妇女中,子痫前期/子痫的决定因素。
方法
采用基于医院的不匹配病例对照研究设计。这项研究是在 2015 年 12 月至 2016 年 2 月期间在亚的斯亚贝巴的两家公立医院进行的,样本量为 291 人(97 例病例和 194 例对照)。患有子痫前期/子痫的妇女为病例,未被诊断为子痫前期/子痫的妇女为对照。采用病例对照发生率密度抽样,随后进行访谈员管理,使用经过预测试的问卷进行。数据输入 Epi Info 7 软件,并导出到 STATA 14 进行清理和分析。使用表格描述性统计数据显示病例和对照之间的数据。采用卡方检验比较病例和对照之间的分类变量。进行单变量和多变量逻辑回归分析,以确定子痫前期/子痫的决定因素。
结果
与子痫前期或子痫有统计学显著关联的因素有初产妇(AOR:2.68,95%CI:1.38,5.22)、既往妊娠子痫前期史(AOR:4.28,95%CI:1.61,11.43)、多胎妊娠(AOR:8.22,95%CI:2.97,22.78)、孕期接受营养咨询(AOR:0.22,95%CI:0.1,0.48)和孕期饮酒(AOR:3.97,95%CI:1.8,8.75)。
结论
本研究确定了子痫前期/子痫的保护和危险因素。为了及时诊断和治疗子痫前期,卫生工作者应特别关注初产妇和多胎妊娠的妇女。此外,医疗保健提供者应在 ANC 期间提供营养咨询,包括避免在怀孕期间饮酒。