Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA.
John Snow Inc., Tigrai Field Office, Mekelle, Ethiopia.
Int J Gynaecol Obstet. 2018 Apr;141(1):113-119. doi: 10.1002/ijgo.12438. Epub 2018 Jan 31.
To identify perinatal mortality risk factors in the Southern Zone of Tigray, northern Ethiopia.
The present unmatched case-control study included data from 20 health facilities; stillbirths and neonatal deaths were included as a case group and patients with neonates who survived until discharge or day 7 postpartum were included as a control group. Perinatal mortality risk factors were investigated using bivariate and multivariate logistic regression analyses.
There were 126 and 252 patients included in the case and control groups, respectively. Prematurity (adjusted odds ratio [AOR] 12.2; 95% confidence interval [CI] 3.46-43.17; P<0.001), delivery weight below 2500 g (AOR 11.5, 95% CI 3.16-42.36; P<0.001), and fewer prenatal visits (AOR 5.4; 95% CI 0.80-36.63; P=0.028) were determinants of perinatal mortality. Partograph use (AOR 0.2; 95% CI 0.08-0.48; P<0.001) and seeking labor care at the start of labor (AOR 0.1; 95% CI 0.01-0.96; P=0.010) were protective. Short childbirth interval (<2 years) (AOR 2.2; 95% CI 1.03-5.09; P=0.013), distance to facility (AOR 3.7; 95% CI 1.56-9.02; P=0.007), and lack of iron supplementation (AOR 3.3; 95% CI 1.16-9.76; P=0.021) were also predictors of perinatal mortality.
Perinatal mortality was linked to prematurity and low delivery weight. Interventions including partograph and auscultation, as well as subsidizing transport and iron supplementation, could help in this region.
在埃塞俄比亚北部提格雷地区南部确定围产期死亡的危险因素。
本项非匹配病例对照研究纳入了 20 家医疗机构的数据;将死产和新生儿死亡纳入病例组,将存活至出院或产后第 7 天的新生儿患者纳入对照组。采用单变量和多变量逻辑回归分析调查围产期死亡的危险因素。
病例组和对照组分别纳入了 126 例和 252 例患者。早产(调整后的优势比 [AOR] 12.2;95%置信区间 [CI] 3.46-43.17;P<0.001)、出生体重低于 2500g(AOR 11.5,95%CI 3.16-42.36;P<0.001)和产前检查次数较少(AOR 5.4;95%CI 0.80-36.63;P=0.028)是围产期死亡的决定因素。使用产程图(AOR 0.2;95%CI 0.08-0.48;P<0.001)和在产程开始时寻求分娩护理(AOR 0.1;95%CI 0.01-0.96;P=0.010)是保护因素。分娩间隔较短(<2 年)(AOR 2.2;95%CI 1.03-5.09;P=0.013)、距离医疗机构远(AOR 3.7;95%CI 1.56-9.02;P=0.007)和缺乏铁补充(AOR 3.3;95%CI 1.16-9.76;P=0.021)也是围产期死亡的预测因素。
围产期死亡与早产和低出生体重有关。在该地区,可以采取包括产程图和听诊在内的干预措施,并提供交通和铁补充补贴。