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基拉基拉的围产期死亡率居高不下:所罗门群岛各省在实现卫生领域可持续发展目标方面仍遥不可及。

High perinatal mortality rates persist in Kirakira: The sustainable development goals for health remain out of reach in the provinces of Solomon Islands.

作者信息

Jones Peter D, Balasundaram Niroshan, D'Costa Lloyd, Kacker Kunaal, Kaludewa Amila, Fink James

机构信息

Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.

Department of Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.

出版信息

J Paediatr Child Health. 2018 Aug;54(8):895-899. doi: 10.1111/jpc.13919. Epub 2018 Apr 14.

DOI:10.1111/jpc.13919
PMID:29655292
Abstract

AIM

This study aimed to calculate the perinatal mortality rate in Kirakira Hospital, a remote provincial hospital in Solomon Islands, over a 3-year period, from 2014 to 2016.

METHODS

A retrospective audit of the labour ward admission books for the years 2014-2016 was conducted. Patient files of all perinatal deaths and caesarean sections were accessed and reviewed. Stillbirths and early neonatal deaths were classified, and results were compared with the national health statistics of Australia (2014).

RESULTS

Between 2014 and 2016, there were 1311 births and 40 perinatal deaths (mortality rate of 31 per 1000). This is approximately three times the Australian rate of 9.6 deaths per 1000. Of these deaths, 28 were stillbirths, and 12 were neonatal deaths. Detailed information was available for 88% (35/40) of the perinatal deaths. Only 15 caesarean sections (1.1% of deliveries) were performed, compared to a rate of 32.1% of caesarean sections in Australia (2014).

CONCLUSIONS

Kirakira continues to have a very high perinatal mortality rate that has not changed over the last 6 years. The rate is double that reported for Solomon Islands in current World Health Organization data. This discrepancy is likely due to an absence of clinical data outside of the National Referral Hospital in Honiara. This paper identifies clinical indicators that could be targeted to help lower the perinatal mortality rate in this remote and impoverished community.

摘要

目的

本研究旨在计算2014年至2016年这三年间,所罗门群岛一家偏远省级医院——基拉基拉医院的围产期死亡率。

方法

对2014 - 2016年产房入院登记簿进行回顾性审计。查阅并审查了所有围产期死亡病例和剖宫产病例的患者档案。对死产和早期新生儿死亡进行分类,并将结果与澳大利亚2014年的国家卫生统计数据进行比较。

结果

2014年至2016年期间,共分娩1311例,围产期死亡40例(死亡率为每1000例31例)。这大约是澳大利亚每1000例9.6例死亡发生率的三倍。在这些死亡病例中,28例为死产,12例为新生儿死亡。88%(35/40)的围产期死亡病例有详细信息。仅进行了15例剖宫产(占分娩数的1.1%),而澳大利亚2014年的剖宫产率为32.1%。

结论

基拉基拉医院的围产期死亡率仍然非常高,且在过去6年中没有变化。该比率是世界卫生组织当前数据中所报道的所罗门群岛比率的两倍。这种差异可能是由于霍尼亚拉国家转诊医院之外缺乏临床数据所致。本文确定了一些临床指标,可针对这些指标来帮助降低这个偏远贫困社区的围产期死亡率。

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