埃塞俄比亚西北部德布雷塔博尔综合医院收治的孕妇胎膜早破的患病率及其相关因素：基于机构的横断面研究
Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study.
作者信息
Addisu Dagne, Melkie Abenezer, Biru Shimeles
机构信息
Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
出版信息
Obstet Gynecol Int. 2020 May 14;2020:4034680. doi: 10.1155/2020/4034680. eCollection 2020.
BACKGROUND
In Ethiopia, preterm premature rupture of membrane is defined as loss of amniotic fluid before the onset of labor in pregnancy >28 weeks of gestation but before 37 weeks. It is a significant cause of perinatal, neonatal, and maternal morbidity and mortality both in high- and low-income countries. Due to different factors associated with the quality of health care given and socioeconomic factors, the effect of preterm premature rupture of membrane is worsen in low-income countries. Little evidence is available about the problem in the study area. Therefore, this study was aimed to determine the prevalence of preterm premature rupture of membrane and its associated factors among pregnant women admitted in Debre Tabor General Hospital.
METHODS
Facility-based cross-sectional study was conducted. A total of 424 mothers were included in the study. Systematic random sampling was used to select study participants. A combination of chart review and interview was used to collect the data. Both descriptive and analytical statistics were computed.
RESULT
The prevalence of preterm premature rupture of membrane was found to be 13.7%. Pregnant women with abnormal vaginal discharge (AOR = 5.30, 95% CI = 2.07-13.52), urinary tract infection (AOR = 2.62, 95% CI = 1.32-5.19), history of premature rupture of membrane (AOR = 3.31, 95% CI = 1.32-8.27), vaginal bleeding (AOR = 2.58, 95% CI = 1.14-5.82), and mid-upper arm circumference <23 cm (AOR = 6.26, 95% CI = 3.21-12.20) were associated with preterm premature rupture of membrane.
CONCLUSIONS
The prevalence of preterm premature rupture of membrane was high. Abnormal vaginal discharge, urinary tract infection, vaginal bleeding, previous premature rupture of membrane, and mid-upper arm circumference <23 cm were associated with preterm premature rupture of membrane. Thus, early screening and treatment of urinary tract infections and abnormal vaginal discharges were recommended to reduce the risk of preterm premature rupture of membrane.
背景
在埃塞俄比亚，胎膜早破被定义为妊娠28周以上但未满37周时临产前羊水流失。在高收入和低收入国家，它都是围产期、新生儿期及孕产妇发病和死亡的重要原因。由于与所提供医疗保健质量及社会经济因素相关的不同因素，低收入国家中胎膜早破的影响更为严重。关于研究地区该问题的证据很少。因此，本研究旨在确定德布雷塔博尔综合医院收治的孕妇中胎膜早破的患病率及其相关因素。
方法
开展了一项基于机构的横断面研究。共有424名母亲纳入研究。采用系统随机抽样方法选择研究参与者。通过病历审查和访谈相结合的方式收集数据。同时进行描述性和分析性统计计算。
结果
发现胎膜早破的患病率为13.7%。阴道分泌物异常的孕妇（比值比=5.30，95%置信区间=2.07 - 13.52）、尿路感染的孕妇（比值比=2.62，95%置信区间=1.32 - 5.19）、有胎膜早破病史的孕妇（比值比=3.31，95%置信区间=1.32 - 8.27）、阴道出血的孕妇（比值比=2.58，95%置信区间=1.14 - 5.82）以及上臂中段周长<23厘米的孕妇（比值比=6.26，95%置信区间=3.21 - 12.20）与胎膜早破有关。
结论
胎膜早破的患病率较高。阴道分泌物异常、尿路感染、阴道出血、既往胎膜早破以及上臂中段周长<23厘米与胎膜早破有关。因此，建议对尿路感染和阴道分泌物异常进行早期筛查和治疗，以降低胎膜早破的风险。
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