Zimba Mission Hospital, Zimba, Zambia.
Ehime University, Ehime, Japan.
BMC Pregnancy Childbirth. 2019 Mar 12;19(1):90. doi: 10.1186/s12884-019-2231-9.
Globally, 2.6 million stillbirths occur every year. Of these, 98% occur in developing countries. According to the United Nations Children's Fund, the neonatal mortality rate in Zambia in 2014 was 2.4%. In 2016, the World Health Organization released the International Classification of Diseases - Perinatal Mortality (ICD-PM) as a globally applicable and comparable system for the classification of the causes of perinatal deaths. However, data for developing countries are scarce. The aim of this study was to evaluate the rates and causes of stillbirths and neonatal deaths at a local hospital in Zimba, Zambia to identify opportunities for preventive interventions.
All cases of stillbirths and neonatal deaths at Zimba Mission Hospital in Zambia in 2017 were included in this study. Outborn neonates who were transferred to the hospital and later died were also included in the study. Causes of stillbirths and neonatal deaths were analyzed and classified according to ICD-PM.
In total, 1754 babies were born via 1704 deliveries at the hospital, and 28 neonates were transferred to the hospital after birth. The total number of perinatal deaths was 75 (4.2%), with 7 deaths in the antepartum, 25 deaths in the intrapartum, and 43 deaths in the neonatal period. Most antepartum deaths (n = 5; 71.4%) were classified as fetal deaths of unspecified causes. Intrapartum deaths were due to acute intrapartum events (n = 21; 84.0%) or malformations, deformations, or chromosomal abnormalities (n = 4; 16.0%). Neonatal deaths were related primarily to complications from intrapartum events (n = 19; 44.2%); low birth weight or prematurity (n = 16; 37.2%); or infection (n = 3; 7.0%).
Perinatal deaths were associated with acute intrapartum events and considered preventable in 40 cases (53.3%). Effective interventions to prevent perinatal deaths are needed.
全球每年仍有 260 万例死产。其中，98%发生在发展中国家。根据联合国儿童基金会的数据，2014 年赞比亚的新生儿死亡率为 2.4%。2016 年，世界卫生组织发布了《国际疾病分类-围产儿死亡（ICD-PM）》，作为一种适用于全球且可比较的围产儿死亡原因分类系统。然而，发展中国家的数据却很匮乏。本研究旨在评估赞比亚津巴地区医院的死产和新生儿死亡发生率和原因，以确定预防干预的机会。
本研究纳入了 2017 年在赞比亚津巴使命医院发生的所有死产和新生儿死亡病例。在医院出生后转院死亡的新生儿也包括在研究中。根据 ICD-PM 对死产和新生儿死亡的原因进行分析和分类。
共有 1704 例分娩中有 1754 名婴儿在该医院出生，有 28 名新生儿在出生后转院至该医院。围产儿总死亡人数为 75 例（4.2%），其中产前死亡 7 例，产时死亡 25 例，新生儿期死亡 43 例。大多数产前死亡（n=5；71.4%）被归类为原因不明的胎儿死亡。产时死亡是由于急性产时事件（n=21；84.0%）或畸形、变形或染色体异常（n=4；16.0%）。新生儿死亡主要与产时事件的并发症有关（n=19；44.2%）；低出生体重或早产（n=16；37.2%）；或感染（n=3；7.0%）。
围产儿死亡与急性产时事件相关，其中 40 例（53.3%）被认为是可预防的。需要采取有效的干预措施来预防围产儿死亡。
