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埃塞俄比亚西北部德布雷马科斯转诊医院产前检查孕妇中先兆子痫的发病率及预测因素:前瞻性队列研究

Incidence and Predictors of Pre-Eclampsia Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, North West Ethiopia: Prospective Cohort Study.

作者信息

Birhanu Molla Yigzaw, Temesgen Habtamu, Demeke Gebreselassie, Assemie Moges Agazhe, Alamneh Alehegn Aderaw, Desta Melaku, Toru Milkiyas, Ketema Daniel Bekele, Leshargie Cheru Tesema

机构信息

Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Department of Human Nutrition and Food Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Int J Womens Health. 2020 Nov 10;12:1013-1021. doi: 10.2147/IJWH.S265643. eCollection 2020.

Abstract

BACKGROUND

Pre-eclampsia is a pregnancy-induced hypertension that occurs after 20 weeks of gestation. It is the leading cause of maternal and perinatal morbidity and mortality globally, but it is higher in developing countries. In Ethiopia, conducting research on the incidence and predictors of pre-eclampsia is crucial due to the paucity of information.

METHODS

A prospective cohort study was undertaken using 242 pregnant women between November 1, 2018 and March 30, 2019 at Debre Markos Referral Hospital. All eligible women who fulfilled the inclusion criteria were included in this study. Data were entered into the epic-data Version 4.2 and analyzed using the STATA Version 14.0 software. The Cox-proportional hazard regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Pre-eclampsia free survival time was estimated using the Kaplan-Meier survival curve. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify predictors of pre-eclampsia.

RESULTS

The overall incidence rate of pre-eclampsia was 3.35 per 100 person-years. Having a pre-existing history of diabetes mellitus [AHR=2.7 (95% CI=1.43-8.81)], having a history of multiple pregnancy [AHR=3.4 (95% CI=2.8-6.9)] and being ≥35 years old age [AHR=2.5 (95% CI=1.42-3.54)] were the significant predictors of pre-eclampsia.

CONCLUSION

The incidence of pre-eclampsia was high in this study. Having (pre-existing diabetes and multiple pregnancy) and being ≥35 years old age were the significant predictors of pre-eclampsia. Inspiring pregnant women's health-seeking behavior should provide a chance to diagnose pre-eclampsia early to prevent the medical complication of pre-eclampsia.

摘要

背景

子痫前期是一种妊娠诱发的高血压疾病,发生于妊娠20周之后。它是全球孕产妇和围产儿发病及死亡的主要原因,但在发展中国家更为高发。在埃塞俄比亚,由于信息匮乏,开展关于子痫前期发病率及预测因素的研究至关重要。

方法

于2018年11月1日至2019年3月30日在德布雷马尔科斯转诊医院对242名孕妇进行了一项前瞻性队列研究。所有符合纳入标准的合格女性均纳入本研究。数据录入epic - data 4.2版本,并使用STATA 14.0软件进行分析。拟合Cox比例风险回归模型,并使用Cox - Snell残差检验评估拟合优度。采用Kaplan - Meier生存曲线估计无子痫前期生存时间。拟合双变量和多变量Cox比例风险回归模型以确定子痫前期的预测因素。

结果

子痫前期的总体发病率为每100人年3.35例。既往有糖尿病史[AHR = 2.7(95%CI = 1.43 - 8.81)]、有多次妊娠史[AHR = 3.4(95%CI = 2.8 - 6.9)]以及年龄≥35岁[AHR = 2.5(95%CI = 1.42 - 3.54)]是子痫前期的显著预测因素。

结论

本研究中子痫前期的发病率较高。有(既往糖尿病和多次妊娠)以及年龄≥35岁是子痫前期的显著预测因素。鼓励孕妇的就医行为应能提供早期诊断子痫前期的机会,以预防子痫前期的医学并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/783e/7667502/72f2398ab1a2/IJWH-12-1013-g0001.jpg

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