Department of Pediatrics, University of North Carolina School of Medicine, 101 Manning Drive, CB 7596, Chapel Hill, NC, 27599-7596, USA.
Department of Radiology, Harborview Medical Center, University of Washington Medical Center, Seattle, WA, USA.
BMC Pregnancy Childbirth. 2019 Jul 22;19(1):258. doi: 10.1186/s12884-019-2412-6.
In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models with general estimating equations to control for cluster-level effects. The diagnosis of polyhydramnios was confrimed by an U.S. based radiologist in a majority of cases (62%).
We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13).
Polyhydramnios occured in these low and low-middle income countries at a rate similar to high-income contries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.
NCT01990625 , November 21, 2013.
在许多低收入和中低收入国家，羊水过多的发病率尚不清楚，部分原因是超声技术未常规使用。我们的目的是报告五个低收入和中低收入国家的羊水过多发病率，确定与羊水过多相关的产妇特征，并报告妊娠和新生儿结局。
我们对多国、集群随机产前保健超声试验——First Look 研究进行了二次分析。我们评估了所有在危地马拉、巴基斯坦、赞比亚、肯尼亚和刚果民主共和国（DRC）接受产前超声检查的入组妇女。我们使用配对的地点比较和 Tukey-Kramer 调整，以及具有广义估计方程的多变量逻辑模型来控制集群水平的影响。大多数情况下（62%），通过美国放射科医生确认羊水过多的诊断。
我们发现 305/18640（1.6%）例羊水过多。229（75%）例来自 DRC，发病率为 10%。羊水过多的女性中，梗阻性分娩（7%比 4%）和胎儿位置不正（4%比 2%）更为常见。当存在羊水过多时，新生儿死亡更为常见（OR 2.43；95%CI 1.15, 5.13）。
在这些低收入和中低收入国家，羊水过多的发生率与高收入国家相似，但 DRC 的发病率为 10%。羊水过多与梗阻性分娩、胎儿位置不正和新生儿死亡有关。
NCT01990625，2013 年 11 月 21 日。
