在埃塞俄比亚亚的斯亚贝巴提库尔·安贝萨专科医院分娩的糖尿病母亲的分娩结局。
Birth Outcomes among Diabetic Mothers Who Delivered in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
作者信息
Eshetu Bajrond, Sintayehu Yitagesu, Mekonnen Bazie, Daba Woreknesh
机构信息
Department of Midwifery, College of Health and Medical Sciences, Dire Dawa University, P.O. Box 1362, Dire Dawa, Ethiopia.
Department of Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
出版信息
Adv Med. 2019 Aug 7;2019:6942617. doi: 10.1155/2019/6942617. eCollection 2019.
INTRODUCTION
Diabetes develops in 4% of all the pregnancies worldwide, and its prevalence ranges from 1 to 14%, and 7% are complicated and results in prenatal morbidity and mortality. The disease affects women and their babies during pregnancy, labor, and delivery. However, little is known about its prevalence, birth outcomes, and associated factors in the study setting.
METHOD
A facility-based retrospective cross-sectional study was done on all deliveries attended from January 1, 2015, to December 31, 2017, to determine the prevalence of diabetes and birth outcome. The mothers who had complete data record were identified and consecutively reviewed. The data were entered in EpiData Version 4.2 and exported to SPSS Version 23.0 for analysis.
RESULTS
Of the 14039 women who gave birth during the study period, 2.6% of them had diabetes mellitus, and from reviewed data, 54.6% had gestational diabetes and 45.4% had pregestational diabetes. Out of the diabetic mothers, 57.8% delivered by cesarean section, 39.9% by spontaneous vaginal delivery, and 26% of the pregnancies ended up with pregnancy-induced hypertension. Regarding the fetal outcome, 17.9% were preterm delivery, 17.6% macrocosmic, 9.2% respiratory distress, 10.1% low birth weight, and 65% admitted to neonatal intensive care unit. Class I obesity and history of PIH were associated with adverse maternal outcomes at aOR = 95%CI 3.8 (1.29, 8.319) and aOR = 95%CI 2.1 (1.03, 4.399), respectively. Being a house wife and preterm deliveries were associated with adverse fetal outcomes at aOR = 95%CI 2.117 (1.315, 3.405) and aOR = 95%CI 9.763 (4.560, 20.902), respectively.
CONCLUSION
The prevalence of diabetes mellitus delivered in the hospital was 2.6%. Class I obesity and previous history of pregnancy-induced hypertension were significantly associated with adverse maternal outcomes, whereas preterm delivery and being housewife were associated with adverse fetal outcome.
引言
全球范围内，4%的妊娠会发展为糖尿病，其患病率在1%至14%之间，其中7%的病例会出现并发症，导致产前发病和死亡。该疾病在孕期、分娩期及产时都会影响产妇及其婴儿。然而，在本研究环境中，关于其患病率、分娩结局及相关因素的了解却很少。
方法
对2015年1月1日至2017年12月31日期间所有分娩病例进行了一项基于机构的回顾性横断面研究，以确定糖尿病患病率及分娩结局。确定并连续审查了拥有完整数据记录的产妇。数据录入EpiData 4.2版本，并导出至SPSS 23.0版本进行分析。
结果
在研究期间分娩的14039名女性中，2.6%患有糖尿病，从审查数据来看，54.6%患有妊娠期糖尿病，45.4%患有孕前糖尿病。在糖尿病产妇中，57.8%通过剖宫产分娩，39.9%通过自然阴道分娩，26%的妊娠最终并发妊娠高血压。关于胎儿结局，17.9%为早产，17.6%为巨大儿，9.2%有呼吸窘迫，10.1%为低出生体重，65%入住新生儿重症监护病房。I级肥胖和妊娠高血压病史分别与不良孕产妇结局相关，调整后比值比（aOR）=95%置信区间（CI）为3.8（1.29，8.319）和aOR=95%CI为2.1（1.03，4.399）。家庭主妇身份和早产分别与不良胎儿结局相关，aOR=95%CI为2.117（1.315，3.405）和aOR=95%CI为9.763（4.560，20.902）。
结论
在该医院分娩的产妇中，糖尿病患病率为2.6%。I级肥胖和既往妊娠高血压病史与不良孕产妇结局显著相关，而早产和家庭主妇身份与不良胎儿结局相关。
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