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母亲相关因素对围产期结局的影响——肯尼亚基苏木县公立和非公立卫生机构中寻求产前护理的母亲的研究。

Effects of mother related factors on perinatal outcomes-a study of mothers seeking antenatal care at public and non-public health facilities in Kisii County, Kenya.

作者信息

Matiang'i Micah, Karanja Simon, Wanzala Peter, Ngure Kenneth, Luciani Albino

机构信息

School of Public Health-Jomo Kenyatta University of Agriculture and Technology.

Centre for public health research, Kenya Medical Research Institute (KEMRI).

出版信息

J Public Health Afr. 2017 Dec 31;8(2):689. doi: 10.4081/jphia.2017.689.

Abstract

The study sought to determine clientlevel and facility-level factors that affect perinatal outcomes among women attending comparable public (government owned) and non-public health facilities (non-government owned) in County-Kenya in the context of free maternity care. A total of 365 pregnant mothers recruited in 4 health facilities during their ANC visit and followed up to 2 weeks post-delivery but only 287 attended all follow-up visits. Study subjects were recruited proportionate to number of deliveries each of the facilities had conducted in the preceding 6 months. The dependent variable was perinatal outcome; independent variables were demographic and clinical factors. Analysis was done using χ, logistic regression, paired t and McNemar's tests. Maternal BMI and a mother's parity were statistically correlated with perinatal outcome (χ= 8.900, d.f =3, P=0.031 and (χ= 13.232, d.f =4, P=0.039) respectively. Mothers with 1 parity were 4.5 times more likely to have normal perinatal outcomes (OR =4.5, 95% CI 2.25-14.29, P=0.012). There was a significant relationship between a mother's knowledge of pregnancy-related issues and the baby's weight (t=-67.8 d.f. 213 P<0.001). Mothers' knowledge on pregnancy issues and spousal involvement influences perinatal outcomes. Dietary Diversity Score (DDS) of a mother does not have a direct influence on the outcome of a pregnancy. There is need to focus on maternal factors that affect perinatal outcomes besides free maternity care.

摘要

该研究旨在确定在肯尼亚某县免费提供孕产妇护理的背景下,影响前往类似的公立(政府所有)和非公立卫生机构(非政府所有)就诊的妇女围产期结局的个体层面和机构层面因素。在4家卫生机构招募了365名怀孕母亲,她们在进行产前检查时被纳入研究,并随访至产后2周,但只有287人参加了所有随访。研究对象根据各机构在前6个月内的分娩数量按比例招募。因变量是围产期结局;自变量是人口统计学和临床因素。采用χ²检验、逻辑回归、配对t检验和McNemar检验进行分析。孕产妇体重指数和母亲的胎次与围产期结局在统计学上具有相关性(χ²= 8.900,自由度 =3,P=0.031;χ²= 13.232,自由度 =4,P=0.039)。胎次为1的母亲围产期结局正常的可能性高4.5倍(比值比 =4.5,95%置信区间2.25 - 14.29,P=0.012)。母亲对妊娠相关问题的了解与婴儿体重之间存在显著关系(t=-67.8,自由度213,P<0.001)。母亲对妊娠问题的了解和配偶的参与会影响围产期结局。母亲的饮食多样性得分(DDS)对妊娠结局没有直接影响。除了免费孕产妇护理外,还需要关注影响围产期结局的孕产妇因素。

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