Eze Paul, Al-Maktari Fatoum, Alshehari Ahmed Hamood, Lawani Lucky Osaheni
Medecins Sans Frontieres OCBA, Barcelona, Spain.
Paediatrics Unit, Al Gomhoury Hospital Hajjah City, Hajjah Governorate, Yemen.
Confl Health. 2020 Jul 29;14:53. doi: 10.1186/s13031-020-00297-7. eCollection 2020.
The protracted conflict in Yemen has taken a massive toll on the health system, negatively impacting the health of children, especially the most vulnerable age group; the newborns.
A 2-year retrospective study of admissions into the Neonatal Intensive Care Unit (NICU) in Al-Gomhoury Hospital Hajjah, Northwest Yemen was conducted. Data was analyzed with IBM SPSS® version 25.0 statistical software using descriptive/inferential statistics.
A total of 976 newborns were eligible and included in this study; 506 preterm newborns (51.8%) and 470 term newborns (48.2%). Over half, 549 (56.3%) newborns were admitted within 24 h after birth and 681 (69.8%) newborns travelled for over 60 min to arrive at the NICU. The most common admission diagnoses were complications of prematurity (341; 34.9%), perinatal asphyxia (336; 34.4%), neonatal jaundice (187; 18.8%), and neonatal sepsis (157, 16.1%). The median length of stay in the NICU was 4 days. There were 213 neonatal deaths (Facility neonatal mortality rate was 218 neonatal deaths per 1000 livebirths); 192 (90.1%) were preterm newborns, while 177 (83.1%) were amongst newborns that travelled for more 60 min to reach the NICU. Significant predictors of neonatal deaths are preterm birth (aOR = 3.09, 95% CI: 1.26-7.59, = 0.014 for moderate preterm neonates; aOR = 6.18, 95% CI: 2.12-18.01, = 0.001 for very preterm neonates; and aOR = 44.59, 95% CI: 9.18-216.61, < 0.001 for extreme preterm neonates); low birth weight (aOR = 3.67, 95% CI: 1.16-12.07, = 0.032 for very low birth weight neonates; and aOR = 17.42, 95% CI: 2.97-102.08, = 0.002 for extreme low birth weight neonates); and traveling for more than 60 min to arrive at the NICU (aOR = 2.32, 95% CI: 1.07-5.04, = 0.033). Neonates delivered by Caesarean section had lower odds of death (aOR = 0.38, 95% CI 0.20-0.73, = 0.004) than those delivered by vaginal birth.
Preterm newborns bear disproportionate burden of neonatal morbidity and mortality in this setting which is aggravated by difficulties in accessing early neonatal care. Community-based model of providing basic obstetric and neonatal care could augment existing health system to improve neonatal survival in Yemen.
也门旷日持久的冲突给卫生系统造成了巨大损失，对儿童健康产生了负面影响，尤其是对最脆弱的年龄组——新生儿。
对也门西北部哈杰省古穆尔医院新生儿重症监护病房（NICU）收治的患者进行了为期2年的回顾性研究。使用IBM SPSS® 25.0统计软件，采用描述性/推断性统计方法对数据进行分析。
本研究共纳入976例符合条件的新生儿；其中506例为早产儿（51.8%），470例为足月儿（48.2%）。超过半数，即549例（56.3%）新生儿在出生后24小时内入院，681例（69.8%）新生儿前往NICU的路程超过60分钟。最常见的入院诊断为早产并发症（341例；34.9%）、围产期窒息（336例；34.4%）、新生儿黄疸（187例；18.8%）和新生儿败血症（157例，16.1%）。在NICU的中位住院时间为4天。共有213例新生儿死亡（机构新生儿死亡率为每1000例活产中有218例新生儿死亡）；192例（90.1%）为早产儿，而177例（83.1%）是前往NICU路程超过60分钟的新生儿。新生儿死亡的显著预测因素包括早产（中度早产儿的调整后比值比[aOR]=3.09，95%置信区间[CI]：1.26 - 7.59，P = 0.014；极早早产儿的aOR = 6.18，95% CI：2.12 - 18.01，P = 0.001；超早早产儿的aOR = 44.59，95% CI：9.18 - 216.61，P < 0.001）；低出生体重（极低出生体重儿的aOR = 3.67，95% CI：1.16 - 12.07，P = 0.032；超低出生体重儿的aOR = 17.42，95% CI：
2.97 - 10
