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埃塞俄比亚提格雷地区孕妇高血压疾病的风险因素:匹配病例对照研究。

Risk factors for hypertensive disorders of pregnancy among mothers in Tigray region, Ethiopia: matched case-control study.

机构信息

School of Nursing, Mekelle University, P.O.Box:1871, Mekelle, Ethiopia.

School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2018 Dec 6;18(1):482. doi: 10.1186/s12884-018-2106-5.

Abstract

BACKGROUND

Hypertensive disorders of pregnancy are a global public health concern both in developed and developing countries. However, evidences regarding the risk factors of hypertensive disorders of pregnancy are limited particularly in Ethiopia. The aim of the study was to assess risk factors associated with hypertensive disorders of pregnancy among mothers in public hospitals of Tigray.

METHODS

The study was conducted in seven public hospitals of Tigray region, Ethiopia from June 2017 to November 2017. A facility based matched case-control study was employed to select 110 cases and 220 controls who were pregnant women. Cases and controls were matched by parity status. A case was a mother diagnosed to have hypertensive disorders of pregnancy by an obstetrician in the antenatal period while a control was a mother who did not have a diagnosis of hypertensive disorders of pregnancy. Data were collected by face to face interview technique using a pretested questionnaire and a checklist. Conditional logistic regression analysis was used to identify the independent predictor variables. Adjusted matched odds ratio with its corresponding 95% confidence interval was used and significance was claimed at P-value less than 0.05. Overall findings were presented in texts and tables.

RESULTS

Rural residents were at greater odds of suffering from hypertensive disorders (OR = 3.7, 95% CI; 1.9, 7.1). Similarly, mothers who consume less amount of fruits in their diet had 5 times higher odds of developing hypertensive disorders than those who consume fruits regularly (OR = 5.1, 95% CI; 2.4, 11.15). Overweight (BMI > 25 Kg/m2) mothers were also at risk of developing hypertensive disorders of pregnancy as compared with the normal and underweight mothers (AOR = 5.5 95% CI; 1.12, 27.6). The risk of developing hypertensive disorders of pregnancy was 5.4 times higher among diabetic mothers.

CONCLUSION

Rural residence, less fruit consumption, multiple pregnancy, presence of gestational diabetes mellitus and pre-pregnancy overweight were identified as independent risk factors in this study. It is recommended that health care givers may use these factors as a screening tool for the prediction, early diagnoses as well as timely interventions of hypertensive disorders of pregnancy.

摘要

背景

妊娠高血压疾病是发达国家和发展中国家共同面临的全球公共卫生问题。然而,有关妊娠高血压疾病危险因素的证据在埃塞俄比亚尤其有限。本研究旨在评估提格雷地区公立医院孕妇妊娠高血压疾病的相关危险因素。

方法

本研究于 2017 年 6 月至 11 月在埃塞俄比亚提格雷地区的 7 家公立医院进行。采用基于设施的病例对照研究,选择 110 例病例和 220 例对照,均为孕妇。病例和对照按产次匹配。病例是指产前由产科医生诊断为妊娠高血压疾病的母亲,对照是指未诊断为妊娠高血压疾病的母亲。通过面对面访谈技术,使用预测试问卷和检查表收集数据。采用条件逻辑回归分析确定独立预测变量。采用调整后的匹配比值比及其相应的 95%置信区间,并以 P 值<0.05 表示差异有统计学意义。总体结果以文本和表格形式呈现。

结果

农村居民发生妊娠高血压疾病的几率更高(OR=3.7,95%CI:1.9,7.1)。同样,饮食中水果摄入量较少的母亲发生妊娠高血压疾病的几率是经常食用水果的母亲的 5 倍(OR=5.1,95%CI:2.4,11.15)。超重(BMI>25 Kg/m2)的母亲与正常和体重不足的母亲相比,也有发生妊娠高血压疾病的风险(AOR=5.5,95%CI:1.12,27.6)。患有糖尿病的母亲发生妊娠高血压疾病的风险是正常母亲的 5.4 倍。

结论

本研究确定农村居民、水果摄入量少、多胎妊娠、妊娠期糖尿病和孕前超重是妊娠高血压疾病的独立危险因素。建议医务人员将这些因素作为预测、早期诊断和及时干预妊娠高血压疾病的筛查工具。

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