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埃塞俄比亚中北部德布雷塔博尔总医院收治的早产儿中透明膜病的负担、死亡率及其决定因素:一项回顾性随访研究。

The burden of hyaline membrane disease, mortality and its determinant factors among preterm neonates admitted at Debre Tabor General Hospital, North Central Ethiopia: A retrospective follow up study.

机构信息

College Health Sciences, Debretabor University, Debretabor, Ethiopia.

Department of Nursing, College Health Sciences, Woldia University, Woldia, Ethiopia.

出版信息

PLoS One. 2021 Mar 30;16(3):e0249365. doi: 10.1371/journal.pone.0249365. eCollection 2021.

Abstract

BACKGROUND

Hyaline membrane disease (HMD) is a leading cause of morbidity and mortality in preterm newborn babies. Though, there are studies related to Hyaline membrane disease inclusive of all neonates, studies related to the burden among preterm neonates were limited. In addition, increasing neonatal mortality in Ethiopia could be related to increase in the burden of hyaline membrane disease among preterm neonates. Therefore, this study was aimed to assess the burden of hyaline membrane disease, mortality and its associated factors among preterm neonate admitted at neonatal intensive care unit, North Central Ethiopia.

METHODOLOGY

An institution-based retrospective follow-up study was conducted among 535 preterm neonates admitted at neonatal intensive care unit from January 1, 2014-December 30, 2017. Data were entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for statistical analysis. Binary logistic regression was used for the analysis. All variables with P-value < 0.25 during bi-variable analysis were considered for multivariable logistic regression. Level of statistical significance was declared at P value ≤0.05.

RESULTS

In the current study, proportion of hyaline membrane disease was 40% (95% CI; 35.8, 44.3) of which 49.5% died. Preterm neonate born with Gestational age of less than 34 weeks of age (Adjusted odd ratio (AOR = 2.64; 95 CI: 1.49, 4.66)), 5th minute Apgar score less than 7 (AOR = 2.2; 95% CI: 1.20, 4.07), and newborn with birth weight of less than 1500 gram (AOR = 2.4, 95% CI: 1.3, 4.3) were predictors of hyaline membrane disease.

CONCLUSIONS

The mean gestational age (±) was 33.46 (±2.55) weeks. The incidence of hyaline membrane disease among preterm admissions was high. Preterm neonate born with gestational age of less than 34 weeks of age, asphyxiated newborns and newborn with birth weight of less than 1500 gram were predictors of hyaline membrane disease. So, emphasis should be given on early screening, follow up and timely interventions for preterm neonate.

摘要

背景

肺透明膜病(HMD)是导致早产儿发病和死亡的主要原因。尽管有一些研究涉及所有新生儿的肺透明膜病,但有关早产儿负担的研究却很有限。此外,埃塞俄比亚新生儿死亡率的上升可能与早产儿肺透明膜病负担的增加有关。因此,本研究旨在评估 2014 年 1 月 1 日至 2017 年 12 月 30 日期间在埃塞俄比亚中北部新生儿重症监护病房(NICU)住院的早产儿肺透明膜病的负担、死亡率及其相关因素。

方法

这是一项基于机构的回顾性随访研究,研究对象为 2014 年 1 月 1 日至 2017 年 12 月 30 日期间在新生儿重症监护病房住院的 535 例早产儿。数据输入 EPi-data 4.2.0.0 并转移到 STATA 版本 14 统计软件进行统计分析。采用二项逻辑回归进行分析。在双变量分析中 P 值 <0.25 的所有变量均被认为是多变量逻辑回归的变量。P 值≤0.05 表示具有统计学意义。

结果

在本研究中,肺透明膜病的比例为 40%(95%CI;35.8,44.3),其中 49.5%死亡。胎龄小于 34 周(调整优势比(AOR)=2.64;95%CI:1.49,4.66)、第 5 分钟 Apgar 评分小于 7(AOR=2.2;95%CI:1.20,4.07)和出生体重小于 1500 克(AOR=2.4,95%CI:1.3,4.3)的早产儿是肺透明膜病的预测因素。

结论

平均胎龄(±)为 33.46(±2.55)周。早产儿肺透明膜病的发病率较高。胎龄小于 34 周的早产儿、窒息新生儿和出生体重小于 1500 克的新生儿是肺透明膜病的预测因素。因此,应重视对早产儿的早期筛查、随访和及时干预。

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