Dibaba Bekem, Edosa Dejene, Hajure Mohammedamin, Gebre Gelawdiwos
Midwifery Department, Public Health and Medical Sciences, Mettu University, Mettu, Ethiopia.
Psychiatry Department, Public Health and Medical Sciences, Mettu University, Mettu, Ethiopia.
J Multidiscip Healthc. 2021 Feb 4;14:271-278. doi: 10.2147/JMDH.S269744. eCollection 2021.
Antepartum hemorrhage is a very serious problem and contributes significantly to maternal and neonatal morbidity and mortality in developing countries including Ethiopia. Identification of risk factors of antepartum hemorrhage will help for prevention and control programs.
An institutional-based case-control study was conducted from July 2013 to June 2016. A simple random sampling technique was employed, and 420 mothers' medical cards were reviewed using a pretested checklist. The data were entered in to EPI-info version 7 and then exported to SPSS version 20 for analysis, and all variables with a -value<0.2 at bivariate logistic regression analysis were considered as a candidate for multivariate logistic regression analysis, and those variables with a -value<0.05 in multiple logistic regression analysis were considered as significantly associated at 95% confidence interval.
Results of the multiple logistic regression showed that those mothers whose age was in the range of 35-44 years were significantly 4-times more likely to present with antepartum hemorrhage as compared to mothers in the age range of 15-24 years. Moreover, mothers who presented with a previous history of cesarean section were 4.7-times more likely to present with antepartum hemorrhage than those who had no previous history of cesarean section. Furthermore, women with a previous history of abortion were 2-times more likely to develop antepartum hemorrhage as compared to women who had no previous history of abortion.
In this study, the factors found to be risk factors of antepartum hemorrhage were maternal age, previous history of cesarean section, and previous history of abortion. Strategies towards reduction of unwanted pregnancy to prevent abortion, pregnancy at advanced age, and to reduce the cesarean section rate should be emphasized.
产前出血是一个非常严重的问题,在包括埃塞俄比亚在内的发展中国家,它对孕产妇和新生儿的发病率及死亡率有重大影响。识别产前出血的风险因素将有助于预防和控制计划。
2013年7月至2016年6月进行了一项基于机构的病例对照研究。采用简单随机抽样技术,使用预先测试的清单对420名母亲的医疗卡进行审查。数据录入EPI-info 7版本,然后导出到SPSS 20版本进行分析,在双变量逻辑回归分析中P值<0.2的所有变量被视为多变量逻辑回归分析的候选变量,在多变量逻辑回归分析中P值<0.05的变量在95%置信区间被视为显著相关。
多变量逻辑回归结果显示,年龄在35 - 44岁之间的母亲出现产前出血的可能性比年龄在15 - 24岁之间的母亲显著高4倍。此外,有剖宫产史的母亲出现产前出血的可能性是没有剖宫产史的母亲的4.7倍。此外,有流产史的女性发生产前出血的可能性是没有流产史的女性的2倍。
在本研究中,发现产前出血的风险因素有产妇年龄、剖宫产史和流产史。应强调采取策略减少意外怀孕以预防流产、高龄妊娠,并降低剖宫产率。