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埃塞俄比亚北部德布雷塔博尔综合医院新生儿的“近失误”情况及其预测因素;一项回顾性分析

Neonatal near Miss and Its Predictors among Neonates Delivered at Debretabor General Hospital, Northern Ethiopia; A Retrospective Analysis.

作者信息

Tassew Habtamu Abie, Kassie Fisseha Yetwale, Mihret Muhabaw Shumye

机构信息

Department of Midwifery, Debretabor University, Debretabor, Ethiopia.

Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Int J Pediatr. 2020 Sep 7;2020:1092479. doi: 10.1155/2020/1092479. eCollection 2020.

Abstract

BACKGROUND

In many low-resource countries, the progress of neonatal mortality reduction is very slow. The scenario is notably true in sub-Saharan Africa including Ethiopia. For every neonatal death, there are lots of near missed neonates. Generating evidences on the extent and predictors of neonatal near miss is a key step in neonatal mortality reduction efforts. However, there is limited evidence in this aspect in Ethiopia.

OBJECTIVE

This study is aimed at assessing the proportion of neonatal near miss and associated factors among neonates delivered at Debretabor General Hospital, Northern Ethiopia, 2019.

METHODS

An institution-based cross-sectional study was conducted on 422 neonates delivered at Debretabor General Hospital from July 1, 2018, to June 30, 2019. Both pragmatic and management criteria of definition of neonatal near miss were utilized. A systematic random sampling technique was used to select the cards of the study participants. Data were extracted with structured and pretested checklist, entered in the EpiData, and then exported to SPSS version 20. Both descriptive and analytical procedures have been done. Descriptive statistics such as frequencies and cross tabulations were carried out. The binary logistic regression model was fitted and variables with value < 0.20 were entered in the multivariable logistic regression model. Both crude and adjusted odds ratios with the corresponding 95% CI were computed. The level of significance has been claimed based on the adjusted odds ratio with 95% CI and its value of ≤0.05.

RESULTS

The proportion of neonates experiencing near miss was obtained to be 32.2% with 95% CI (28, 36). Rural residence (AOR = 4.41; 95% CI: 2.57,7.55), incomplete ANC visit (AOR = 3.16; 95% CI: 1.90,5.25), primiparous (AOR = 2.55; 95% CI: 1.59,4.12), pregnancy-induced hypertension (AOR = 3.23; 95% CI: 1.19,8.78), premature rupture of membrane (AOR = 4.65; 95% CI: 1.70,12,73), cephalic-pelvic disproportion (AOR = 3.05; 95% CI: 1.32,7.01), and antepartum hemorrhage (AOR = 4.95; 95% CI: 1.89,12.96) were the independent predictors of neonatal near-miss. . The proportion of neonatal near miss was found to be high in the study setting. Most of the determinants of near miss are modifiable obstetric-related factors. Hence, stakeholders need to consider the aforesaid factors while they design interventions.

摘要

背景

在许多资源匮乏的国家,降低新生儿死亡率的进展非常缓慢。在包括埃塞俄比亚在内的撒哈拉以南非洲地区,情况尤为如此。每发生一例新生儿死亡,就有许多濒临死亡的新生儿。获取关于新生儿濒临死亡的程度及其预测因素的证据是降低新生儿死亡率努力中的关键一步。然而,埃塞俄比亚在这方面的证据有限。

目的

本研究旨在评估2019年在埃塞俄比亚北部德布雷塔博尔综合医院分娩的新生儿中濒临死亡的比例及其相关因素。

方法

对2018年7月1日至2019年6月30日在德布雷塔博尔综合医院分娩的422名新生儿进行了一项基于机构的横断面研究。采用了新生儿濒临死亡定义的实用标准和管理标准。使用系统随机抽样技术选择研究参与者的卡片。通过结构化且经过预测试的检查表提取数据,输入EpiData,然后导出到SPSS 20版本。进行了描述性和分析性程序。进行了频率和交叉表等描述性统计。拟合了二元逻辑回归模型,并将P值<0.20的变量纳入多变量逻辑回归模型。计算了粗比值比和调整后的比值比以及相应的95%置信区间。根据调整后的比值比及其95%置信区间和P值≤0.05确定显著性水平。

结果

发现经历濒临死亡的新生儿比例为32.2%,95%置信区间为(28, 36)。农村居住(AOR = 4.41;95%置信区间:2.57, 7.55)、产前检查不全(AOR = 3.16;95%置信区间:1.90, 5.25)、初产妇(AOR = 2.55;95%置信区间:1.59, 4.12)、妊娠高血压(AOR = 3.23;95%置信区间:1.19, 8.78)、胎膜早破(AOR = 4.65;95%置信区间:1.70, 12.73)、头盆不称(AOR = 3.05;95%置信区间:1.32, 7.01)和产前出血(AOR = 4.95;95%置信区间:1.89, 12.96)是新生儿濒临死亡的独立预测因素。在研究环境中发现新生儿濒临死亡的比例很高。大多数濒临死亡的决定因素是可改变的与产科相关的因素。因此,利益相关者在设计干预措施时需要考虑上述因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7519192/e029dd9f566e/IJPEDI2020-1092479.001.jpg

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