Matiang'i Micah, Karanja Simon, Wanzala Peter, Ngure Kenneth, Luciani Albino
School of Public Health-Jomo Kenyatta University of Agriculture and Technology.
Centre for public health research, Kenya Medical Research Institute (KEMRI).
J Public Health Afr. 2017 Dec 31;8(2):689. doi: 10.4081/jphia.2017.689.
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.
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。
