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埃塞俄比亚中部奥罗米亚地区北绍阿区医院死产的决定因素:一项病例对照研究。

Determinants of stillbirth in hospitals of North Shoa Zone, Oromia region, Central Ethiopia: A case control study.

作者信息

Gizaw Workineh, Feyisa Mulugeta, Hailu Dejene, Nigussie Tadesse

机构信息

Department of Midwifery, College of Health Sciences, Salale University, Fitche, Ethiopia.

Department of Nursing, College of Health Sciences, Salale University, Fitche, Ethiopia.

出版信息

Heliyon. 2021 May 18;7(5):e07070. doi: 10.1016/j.heliyon.2021.e07070. eCollection 2021 May.

Abstract

BACKGROUND

World Health Organization defined stillbirth as birth of fetus at 28 weeks or above gestation with a birth weight of ≥1000 g or body length of ≥35 cm. Majority of stillbirths occur in low and middle income nations. Efforts made in Ethiopia to improve maternal and child health are showing encouraging results, even though the magnitude didn't reach the expected level. Identification of determinants of stillbirth is quite substantial to apply further meaningful actions.

OBJECTIVE

To assess the determinants of stillbirth in hospitals of North Shoa Zone, Oromia region, Central Ethiopia.

METHOD

Institution based unmatched Case control study was conducted from March 01 to May 30/2019 among 342 women who gave birth in Fitche, Kuyu, Gundomeskel, and Muketurihospitals. Sample size was calculated by using Epi-info version 7.1.1 software package. Statistical Package for Social Sciences version 25 was used to analyze the data. Descriptive statistics, bivariate and multivariate logistic regression analysis were conducted. Variables having P-value ≤ 0.05 in multivariable logistic regression were considered as statistically significant.

RESULT

Type of labor (AOR = 3.79, 95%CI = 1.53, 9.38), duration of labor (AOR = 3.59, 95% CI = 1.53, 8.33), mal-presentation (AOR = 3.45, 95%CI = 1.99, 9.8), preeclampsia/eclampsia (AOR = 4.58, 95%CI = 1.45, 14.48) and birth defect (AOR = 3.05, 95%CI = 1.31, 7.1) were found to be the determinants of stillbirth.

CONCLUSION AND RECOMMENDATION

Causes of still birth in more than two third of the cases were identified. Type of labor, duration of labor, mal presentation, preeclampsia/eclampsia were identified as determinants of stillbirth from mothers' side while birth defect was found to be determinant of stillbirth from fetal side. Heath care providers, policy makers, and other stakeholders, should focus on identified factors to combat problems associated with still birth.

摘要

背景

世界卫生组织将死产定义为妊娠28周及以上、出生体重≥1000克或身长≥35厘米的胎儿出生。大多数死产发生在低收入和中等收入国家。埃塞俄比亚为改善母婴健康所做的努力虽未达到预期水平,但已取得令人鼓舞的成果。确定死产的决定因素对于采取进一步有意义的行动至关重要。

目的

评估埃塞俄比亚中部奥罗米亚州北绍阿地区医院的死产决定因素。

方法

2019年3月1日至5月30日,在菲切、库尤、贡多梅斯凯尔和穆克图里医院对342名分娩妇女进行了基于机构的非匹配病例对照研究。使用Epi-info 7.1.1软件包计算样本量。采用社会科学统计软件包第25版对数据进行分析。进行了描述性统计、双变量和多变量逻辑回归分析。多变量逻辑回归中P值≤0.05的变量被视为具有统计学意义。

结果

产程类型(比值比[AOR]=3.79,95%置信区间[CI]=1.53,9.38)、产程持续时间(AOR=3.59,95%CI=1.53,8.33)、胎位异常(AOR=3.45,95%CI=1.99,9.8)、先兆子痫/子痫(AOR=4.58,95%CI=1.45,14.48)和出生缺陷(AOR=3.05,95%CI=1.31,7.1)被发现是死产的决定因素。

结论与建议

确定了超过三分之二病例的死产原因。产程类型、产程持续时间、胎位异常、先兆子痫/子痫被确定为母亲方面死产的决定因素,而出生缺陷被发现是胎儿方面死产的决定因素。医疗保健提供者、政策制定者和其他利益相关者应关注已确定的因素,以解决与死产相关的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/547a/8141871/9abc75b0a065/gr1.jpg

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