School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
BMC Pregnancy Childbirth. 2021 Mar 16;21(1):209. doi: 10.1186/s12884-021-03683-y.
Antenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems. Maternal near miss (MNM), as an indicator of maternal health, is increasingly gaining global attention to measure these problems. However, little has been done to measure the effect of ANC on MNM in Ethiopia. Therefore, this study is aimed at determining the effect of ANC on MNM and its associated predictors at Gamo Gofa zone, southern Ethiopia.
Employing a retrospective cohort study design, 3 years data of 1440 pregnant mothers (480 ANC attendant and 960 non-attendant) were collected from all hospitals in the zone. Taking ANC visit as an exposure variable; we used a pretested checklist to extract relevant information from the study participants' medical records. Characteristics of study participants, their ANC attendance status, MNM rates and associated predictors were determined.
Twenty-five (5.2%) ANC attendant and seventy-one (7.4%) non-attendant mothers experienced MNM, (X = 2,46, df = 2, p = 0.12). The incidence rates were 59.6 (95% CI: 40.6-88.2) and 86.1 (95%CI: 67.3-107.2)/1000 person-years for the ANC attendant and non-attendant mothers, respectively. Mothers who were living in rural areas had higher hazard ratio of experiencing MNM than those who were living in urban areas, with an adjusted hazard ratio (AHR) of 1.68 (95% CI, 1.01, 2.78).
ANC attendance tended to reduce MNM. However, late initiation and loss to follow-up were higher in the current study. Therefore, on time initiation and consistent utilization of ANC are required.
产前护理 (ANC) 提供了一个预防、识别和干预产妇健康问题的机会。产妇接近死亡 (MNM) 作为产妇健康的一个指标，越来越受到全球关注，用于衡量这些问题。然而，在埃塞俄比亚，很少有人致力于衡量 ANC 对 MNM 的影响。因此，本研究旨在确定 ANC 对甘莫高法地区产妇接近死亡的影响及其相关预测因素。
采用回顾性队列研究设计，从该地区的所有医院收集了 1440 名孕妇（480 名 ANC 护理者和 960 名非护理者）的 3 年数据。将 ANC 就诊作为暴露变量；我们使用预先测试的检查表从研究参与者的病历中提取相关信息。确定了研究参与者的特征、他们的 ANC 就诊状况、MNM 发生率和相关预测因素。
25 名（5.2%）ANC 护理者和 71 名（7.4%）非护理者母亲经历了 MNM，（X=2，df=2，p=0.12）。ANC 护理者和非护理者母亲的发生率分别为 59.6（95%CI：40.6-88.2）和 86.1（95%CI：67.3-107.2）/1000人年。居住在农村地区的母亲比居住在城市地区的母亲经历 MNM 的风险更高，调整后的风险比（AHR）为 1.68（95%CI，1.01，2.78）。
ANC 就诊倾向于降低 MNM。然而，在本研究中，起始晚和失访率较高。因此，需要及时开始并持续利用 ANC。
