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埃塞俄比亚东南部奥罗米亚州巴莱地区医院分娩死产的决定因素:一项病例对照研究

Determinants of Stillbirth Among Deliveries Attended in Bale Zone Hospitals, Oromia Regional State, Southeast Ethiopia: A Case-Control Study.

作者信息

Mekonnen Dagne Henok, Takele Melku Abulie, Abdurkadir Abdi Adem

机构信息

World Vision Ethiopia, Hawassa, Ethiopia.

Department of Public Health, Madda Walabu University Goba Referral Hospital School of Health Science, Bale Goba, Ethiopia.

出版信息

Int J Womens Health. 2021 Jan 8;13:51-60. doi: 10.2147/IJWH.S276638. eCollection 2021.

Abstract

BACKGROUND

Stillbirth is one of the adverse outcomes of pregnancy, and it is among the major public health problems in developing countries including Ethiopia. Stillbirth has wide-reaching consequences for parents, care providers, community and society at large.

PURPOSE

To assess the determinant of stillbirth among deliveries attended in Bale zone hospitals Southeast Ethiopia.

METHODS

An institution-based unmatched case-control study was conducted. Cases were deliveries whose birth outcome was stillbirth and controls were deliveries with live birth. A pretested and structured checklist was used to collect data from a sample of 402 (134 cases and 268 controls). Systematic random sampling was used to recruit samples from a list of charts in the delivery registration book. Data were entered into EpiData version 4.2 and exported to SPSS version 20 for analysis. Crude and adjusted odds ratio with 95%CI was calculated and -value <0.05 was used to declare statistical significance.

RESULTS

A total of 402 charts of mothers (134 cases and 268 controls) were included in the analysis. Preceding birth interval <24 months (AOR: 2.991; 95%CI: 1.351-6.621), antenatal visit started at third trimester (AOR: 2.739; 95%CI: 1.048-7.158), referred from other health facility (AOR: 3.215; 95%CI: 1.430-7.229), labor length ≥24 h (AOR: 3.169; 95%CI: 1.241-8.091), presence of meconium stained amniotic fluid (AOR: 2.670; 95%CI: 1.082-6.592) and giving birth to a baby <2500 g (AOR: 3.155; 95%CI: 1.235-8.07) were determinants of stillbirth.

CONCLUSION

Preceding birth interval of <24 months, antenatal visit started at third trimester, referred from other health facility, presence of meconium stained amniotic fluid, labor length ≤24 h and giving birth to a baby <2500 g were found the determinants of stillbirth. Intrapartum care, early identification of labor complications and referral system are required.

摘要

背景

死产是妊娠的不良结局之一,是包括埃塞俄比亚在内的发展中国家主要的公共卫生问题之一。死产对父母、医护人员、社区及整个社会都有深远影响。

目的

评估埃塞俄比亚东南部巴勒州各医院分娩中死产的决定因素。

方法

开展了一项基于机构的非匹配病例对照研究。病例为出生结局是死产的分娩,对照为活产分娩。使用经过预测试的结构化检查表从402个样本(134例病例和268例对照)中收集数据。采用系统随机抽样从分娩登记册中的图表列表中选取样本。数据录入EpiData 4.2版本,并导出到SPSS 20版本进行分析。计算粗比值比和调整后的比值比及其95%置信区间,P值<0.05表示具有统计学意义。

结果

分析共纳入402位母亲的图表(134例病例和268例对照)。上次生育间隔<24个月(调整后比值比:2.991;95%置信区间:1.351 - 6.621)、孕晚期开始产前检查(调整后比值比:2.739;95%置信区间:1.048 - 7.158)、从其他医疗机构转诊而来(调整后比值比:3.215;95%置信区间:1.430 - 7.229)、产程≥24小时(调整后比值比:3.169;95%置信区间:1.241 - 8.091)、羊水粪染(调整后比值比:2.670;95%置信区间:1.082 - 6.592)以及分娩体重<2500克的婴儿(调整后比值比:3.155;95%置信区间:1.235 - 8.07)是死产的决定因素。

结论

发现上次生育间隔<24个月、孕晚期开始产前检查、从其他医疗机构转诊而来、羊水粪染、产程≤24小时以及分娩体重<2500克的婴儿是死产的决定因素。需要进行产时护理、尽早识别分娩并发症以及完善转诊系统。

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