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坦桑尼亚达累斯萨拉姆穆希姆比利国家医院低出生体重及24小时围产期结局的预测因素:对产科记录的五年回顾性分析

Predictors of low birth weight and 24-hour perinatal outcomes at Muhimbili National Hospital in Dar es Salaam, Tanzania: a five-year retrospective analysis of obstetric records.

作者信息

Kamala Benjamin Anathory, Mgaya Andrew Hans, Ngarina Matilda Michael, Kidanto Hussein Lesio

机构信息

Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.

Department of Health Science, University of Stavanger, Stavanger, Norway.

出版信息

Pan Afr Med J. 2018 Apr 23;29:220. doi: 10.11604/pamj.2018.29.220.15247. eCollection 2018.

Abstract

INTRODUCTION

The global prevalence of low birth weight (LBW) is 16%, representing more than 20 million infants worldwide, of which 96% are born in low-income countries. This study aimed to determine the prevalence, predictors and perinatal outcomes of LBW newborns.

METHODS

We conducted a retrospective analysis of data obtained from the hospital's obstetric and neonatal database. Descriptive statistics and multivariate logistic regression were performed with 95% confidence intervals (CI).

RESULTS

The prevalence of LBW was 21% (n = 8,011) and two-thirds of these were delivered at term. Seven percent of newborns were stillbirths and 2% died within 24hrs after birth. Logistic regression revealed that primigravida and grand multiparity were associated with LBW (OR: 1.25, 95%CI: 1.15-1.37; and OR: 1.21, 95%CI: 1.01-1.25, respectively). Having <4 antenatal care (ANC) visits was associated with increased odds of LBW (OR: 1.74, 95%CI: 1.59-1.87). Regression models revealed an independent association between LBW and increased odds of stillbirths (OR = 7.20, 95%CI 6.71-7.90), low Apgar score (OR = 3.42, 95%CI: 3.12-3.76) and early neonatal deaths (OR = 1.82, 95%CI: 1.51-2.19).

CONCLUSION

The prevalence of LBW was high and was associated with extreme maternal age groups, grand multiparity, low maternal education, low number of ANC visits and obstetrics risks factors and complications. Both LBW and prematurity were independently associated with poor perinatal outcome. Future interventions should focus on improving the quality of ANC and integrating peripartum emergency obstetric and neonatal care.

摘要

引言

全球低出生体重(LBW)的患病率为16%,全球有超过2000万婴儿受此影响,其中96%出生在低收入国家。本研究旨在确定低出生体重新生儿的患病率、预测因素和围产期结局。

方法

我们对从医院产科和新生儿数据库获得的数据进行了回顾性分析。进行了描述性统计和多变量逻辑回归分析,并给出95%置信区间(CI)。

结果

低出生体重的患病率为21%(n = 8011),其中三分之二为足月分娩。7%的新生儿为死产,2%在出生后24小时内死亡。逻辑回归显示,初产妇和多产与低出生体重有关(OR分别为:1.25,95%CI:1.15 - 1.37;以及OR:1.21,95%CI:1.01 - 1.25)。产前检查(ANC)次数<4次与低出生体重几率增加有关(OR:1.74,95%CI:1.59 - 1.87)。回归模型显示,低出生体重与死产几率增加(OR = 7.20,95%CI 6.71 - 7.90)、阿氏评分低(OR = 3.42,95%CI:3.12 - 3.76)和早期新生儿死亡(OR = 1.82,95%CI:1.51 - 2.19)之间存在独立关联。

结论

低出生体重的患病率很高,并且与产妇年龄极大、多产、产妇教育程度低、产前检查次数少以及产科危险因素和并发症有关。低出生体重和早产均与不良围产期结局独立相关。未来的干预措施应侧重于提高产前检查的质量,并整合产时紧急产科和新生儿护理。

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