母亲产前护理与胎龄小于或等于 32 周的沙特与非沙特早产儿发病率和死亡率差异。
Antenatal care of mothers and morbidity and mortality disparities among preterm Saudi and non-Saudi infants less than or equal to 32 weeks' gestation.
机构信息
From the Neonatal Intensive Care Unit, Hospital of Pediatrics, King Saud Medical City, Riyadh, Saudi Arabia.
From the Obstetric and Gynecology Department, Maternity Hospital, King Saud Medical City, Riyadh, Saudi Arabia.
出版信息
Ann Saudi Med. 2020 Jul-Aug;40(4):290-297. doi: 10.5144/0256-4947.2020.290. Epub 2020 Aug 6.
BACKGROUND
Premature non-Saudi infants comprise a significant proportion of neonatal intensive care unit admissions in Saudi Arabia. Any differences in antenatal care of mothers and neonatal outcomes compared with premature Saudi infants are unreported.
OBJECTIVE
Assess antenatal care of mothers and neonatal outcomes among premature Saudi and non-Saudi infants, and investigate possible reasons for disparities.
DESIGN
Retrospective cohort study.
SETTING
Tertiary care center in Riyadh.
PATIENTS AND METHODS
All neonates of gestational age ≤32 weeks and birthweight <1500 g admitted from 2015 to 2019 were included.
MAIN OUTCOME MEASURES
Antenatal care of mothers and rates of neonatal mortality and morbidity in premature Saudi and non-Saudi infants.
SAMPLE SIZE
755 premature infants, 437 (57.9%) Saudi, 318 (42.1%) non-Saudi.
RESULTS
Saudi mothers received more antenatal steroids and were more likely to have gestational diabetes mellitus (=.01 and .03, respectively). Non-Saudi mothers were more likely to have pregnancy-induced hypertension (=.01). Non-Saudi infants had significantly higher rates of intraventricular hemorrhage, patent ductus arteriosus, pulmonary hemorrhage, bronchopulmonary dysplasia and necrotizing enterocolitis compared with Saudi infants (=.03, <.001, .04, .002, and <.001, respectively). There were no significant differences in mortality rate, early-onset sepsis, and late-onset sepsis between Saudi and non-Saudi infants (=.81, .81, and .12, respectively).
CONCLUSIONS
Disparities exist in the antenatal care of Saudi and non-Saudi women and in the neonatal morbidities of their premature infants. There was no difference in the neonatal mortality rate. More quality improvement initiatives are required to reduce differences in antenatal and neonatal outcomes.
LIMITATIONS
Retrospective, socioeconomic disparities not identified.
CONFLICT OF INTEREST
None.
背景
在沙特阿拉伯，早产儿中非沙特籍婴儿在新生儿重症监护病房的入院比例中占很大比例。与沙特籍早产儿相比，非沙特籍早产儿母亲的产前护理和新生儿结局的任何差异都没有报道。
目的
评估沙特籍和非沙特籍早产儿母亲的产前护理和新生儿结局，并探讨差异的可能原因。
设计
回顾性队列研究。
地点
利雅得的三级护理中心。
患者和方法
纳入了 2015 年至 2019 年期间胎龄≤32 周且出生体重<1500 克的所有新生儿。
主要观察指标
沙特籍和非沙特籍早产儿母亲的产前护理和新生儿死亡率及发病率。
样本量
755 名早产儿，437 名（57.9%）沙特籍，318 名（42.1%）非沙特籍。
结果
沙特籍母亲接受了更多的产前类固醇治疗，且更有可能患有妊娠期糖尿病（分别为=.01 和.03）。而非沙特籍母亲更有可能患有妊娠高血压（=.01）。与沙特籍婴儿相比，非沙特籍婴儿的颅内出血、动脉导管未闭、肺出血、支气管肺发育不良和坏死性小肠结肠炎的发生率显著更高（分别为=.03、<.001、.04、<.002 和<.001）。沙特籍和非沙特籍婴儿的死亡率、早发性败血症和晚发性败血症发生率无显著差异（分别为=.81、.81 和.12）。
结论
沙特籍和非沙特籍妇女的产前护理以及她们的早产儿的新生儿发病率存在差异。新生儿死亡率没有差异。需要采取更多的质量改进措施来减少产前和新生儿结局的差异。
局限性
回顾性研究，未确定社会经济差异。
利益冲突
无。
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