新生儿死亡与相关因素在埃塞俄比亚：一项基于人群的横断面研究。
Neonatal mortality and associated factors in Ethiopia: a cross-sectional population-based study.
机构信息
Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Amhara, Ethiopia.
出版信息
BMC Womens Health. 2021 Apr 16;21(1):156. doi: 10.1186/s12905-021-01308-2.
BACKGROUND
The neonatal period is the most critical time of human life for diseases. Neonatal morbidity and mortality are significant contributors to under-five morbidity and mortality in a low-income country like Ethiopia. Women are one of the key actors for the improvement of maternal, neonatal, and child healthcare utilization. However, there's no evidence on the association of women's decision-making autonomy with neonate death at a national level in Ethiopia. Therefore, this study aimed to assess the neonatal mortality and associated factors in Ethiopia.
METHODS
A total of 5128 neonates born 5 years before the survey from the Ethiopian Demographic and Health Survey 2016 were reviewed. A multivariable logistic regression model was employed to assess the effect of women's autonomy and identify the determinate predictors of neonate death risk.
RESULTS
The rate of neonatal mortality in Ethiopia was 20.7 per 1000 live births). Women's hadn't autonomy in health care increase neonatal death by 2.72 times compared with those that had autonomy. Hadn't postnatal care was caused grown neonatal death by 5.48 times (AOR 5.48, 95% CI 1.29, 23.26). Delivering at a health institution had 0.61 times lowered neonatal death risk compared with delivering at of health institution without a health facility (AOR 0.61, 95% CI 0.38,0.97). Breastfeeding immediately within 1 h after birth had 0.17 times reduce neonatal death risk compared with not initiation of breastfeeding (AOR 0.17, 95% CI 0.12, 0.26). Women's gave birth single had 0.09 times reduced neonatal death risk than those that gave birth multiple (AOR 0.09, 95% CI 0.05, 0.18). Unknowingly, male neonates had a 1.84 times higher risk of death than females (AOR 1.84, 95% CI 1.20, 2.81).
CONCLUSIONS
Neonatal mortality rate was significantly related to women's hadn't decided power on health care, hadn't postnatal care, delivered out of health institution, breastfed not immediately, and gave birth multiple. It is important to encourage mothers autonomy, use postnatal care service, and deliver in health institutions.
背景
新生儿期是人类生命中最关键的时期，疾病多发。在埃塞俄比亚这样的低收入国家，新生儿发病率和死亡率是导致五岁以下儿童发病率和死亡率的重要因素。妇女是改善孕产妇、新生儿和儿童保健利用的关键行为者之一。然而，在埃塞俄比亚全国范围内，没有证据表明妇女的决策自主权与新生儿死亡有关。因此，本研究旨在评估埃塞俄比亚的新生儿死亡率及其相关因素。
方法
本研究回顾了 2016 年埃塞俄比亚人口与健康调查前 5 年出生的 5128 名新生儿。采用多变量逻辑回归模型评估妇女自主权对新生儿死亡的影响，并确定新生儿死亡风险的决定因素。
结果
埃塞俄比亚的新生儿死亡率为每 1000 例活产 20.7 例。与有自主权的妇女相比，没有医疗自主权的妇女使新生儿死亡的风险增加了 2.72 倍。没有进行产后护理使新生儿死亡的风险增加了 5.48 倍（AOR 5.48，95%CI 1.29，23.26）。与在没有卫生设施的医疗机构分娩相比，在医疗机构分娩使新生儿死亡的风险降低了 0.61 倍（AOR 0.61，95%CI 0.38，0.97）。出生后 1 小时内立即母乳喂养使新生儿死亡的风险降低了 0.17 倍（AOR 0.17，95%CI 0.12，0.26）。与多胎分娩的妇女相比，单胎分娩的妇女新生儿死亡的风险降低了 0.09 倍（AOR 0.09，95%CI 0.05，0.18）。在不知道的情况下，男婴的死亡风险比女婴高 1.84 倍（AOR 1.84，95%CI 1.20，2.81）。
结论
新生儿死亡率与妇女没有决策权、没有产后护理、在医疗机构外分娩、没有立即母乳喂养以及多胎分娩显著相关。鼓励母亲自主、使用产后护理服务和在医疗机构分娩非常重要。
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