Pradhan Dinesh, Nishizawa Yoriko, Chhetri Hari P
Department of Pediatrics, Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Jigme Dorji Wangchuck National Referral Hospital, Thimphu 11001, Bhutan.
Department of Pediatrics, Jigme Dorji Wangchuck National Referral Hospital, Thimphu 11001, Bhutan.
J Trop Pediatr. 2020 Apr 1;66(2):163-170. doi: 10.1093/tropej/fmz046.
Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies.
To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes.
All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU).
Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high.
This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan.
早产相关并发症是全球五岁以下儿童死亡的主要原因。不丹没有可靠的早产率或关于早产婴儿结局的数据。
确定不丹廷布吉格梅·多吉·旺楚克国家转诊医院（JDWNRH）的早产率，并评估其结局。
对2017年1月1日至2017年12月31日在JDWNRH出生的所有存活早产儿进行从出生到出院的随访。收集产妇人口统计学数据、妊娠细节和分娩细节。收集入住新生儿重症监护病房（NICU）的婴儿的发病率、死亡率信息以及出院结局。
活产中的早产率为6.4%。大多数母亲年龄小于30岁，是家庭主妇，接受过中等教育。妊娠登记率和产前检查的充分性较高。大多数早产为单胎妊娠，主要分娩方式为剖宫产。超过一半的分娩为自然发动，男女比例为1.2:1。大多数婴儿为晚期早产且低出生体重。其中一半需要入住NICU。总体死亡率为11%，入住的早产新生儿死亡率为21.6%。早产小于胎龄儿以及医源性早产出生的婴儿死亡风险显著增加。大多数早产新生儿出院时无并发症。宫外生长受限发生率较高。
这是不丹最大的三级护理医院关于早产患病率及其结局的首次研究。
