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孟加拉国一家三级护理医院新生儿重症监护病房的死亡病例审核:一项回顾性病历审查。

Death audit in the neonatal ICU of a tertiary care hospital in Bangladesh: a retrospective chart review.

作者信息

Dey Sanjoy Kumer, Afroze Sharmin, Islam Tariqul, Jahan Ismat, Hassan Shabuj Mohammad Kamrul, Begum Suraiya, Chisti Mohammod Jobayer, Mannan Mohammad Abdul, Shahidullah Mohammod

机构信息

a Department of Neonatology , Bangabandhu Sheikh Mujib Medical University , Dhaka , Bangladesh.

b Department of Paediatrics , Bangabandhu Sheikh Mujib Medical University , Dhaka , Bangladesh.

出版信息

J Matern Fetal Neonatal Med. 2019 Mar;32(5):776-780. doi: 10.1080/14767058.2017.1391779. Epub 2017 Oct 26.

Abstract

BACKGROUND

Expectant reduction of neonatal mortality and formulation of preventive strategies can only be achieved by analysis of risk factors in a particular setting. This study aimed to document incidence of neonatal death and to analyze the risk factors associated with neonatal death.

METHODS

This retrospective study was carried out in department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) over a 12-month period from January to December 2015. The newborns that died within 28 d of life were defined as "Cases" and "Control" were the surviving newborn discharged to home as healthy. Two birth weight and gestational age matched controls were taken for each case. Maternal, obstetric, and newborn characteristics were analyzed between both the groups. Data analysis was performed using SPSS version 20.0 (SPSS Inc., Chicago, IL). A probability of < .05 was considered statistically significant. The strength of association was determined by calculating odds ratio and their 95% confidence intervals (CIs).

RESULTS

During the study period, the proportion of death was 9.6% (64/612). Both in Chi-square analysis and in logistic regression analysis, less than four antenatal visits (odds ratio (OR) 2.78; 95% CI: 1.23-6.28, p = .014) and sepsis (OR 2.37; 95% CI: 1.07-5.26, p = .034) were found to be independent risk factors for deaths, whereas LUCS found to be protective for deaths (OR 0.40; 95% CI: 0.19-0.83, p = .015).

CONCLUSION

In conclusion, less than four antenatal visits and presence of sepsis were found to be independent risk factors whereas LUCS protective of newborn death.

摘要

背景

只有通过分析特定环境中的风险因素,才能实现新生儿死亡率的预期降低并制定预防策略。本研究旨在记录新生儿死亡的发生率,并分析与新生儿死亡相关的风险因素。

方法

这项回顾性研究于2015年1月至12月在班加班杜·谢赫·穆吉布医科大学(BSMMU)新生儿科进行,为期12个月。出生后28天内死亡的新生儿被定义为“病例”,“对照”为健康出院回家的存活新生儿。每个病例选取两名出生体重和胎龄匹配的对照。对两组之间的母亲、产科和新生儿特征进行分析。使用SPSS 20.0版(SPSS公司,伊利诺伊州芝加哥)进行数据分析。概率<0.05被认为具有统计学意义。通过计算比值比及其95%置信区间(CI)来确定关联强度。

结果

在研究期间,死亡比例为9.6%(64/612)。在卡方分析和逻辑回归分析中,产前检查少于四次(比值比(OR)2.78;95%CI:1.23 - 6.28,p = 0.014)和败血症(OR 2.37;95%CI:1.07 - 5.26,p = 0.034)被发现是死亡的独立风险因素,而剖宫产术被发现对死亡有保护作用(OR 0.40;95%CI:0.19 - 0.83,p = 0.015)。

结论

总之,产前检查少于四次和败血症的存在被发现是独立风险因素,而剖宫产术对新生儿死亡有保护作用。

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