Tefera Maleda, Assefa Nega, Roba Kedir Teji, Gedefa Letta
Haramaya University, Harar, Ethiopia.
Glob Pediatr Health. 2021 May 25;8:2333794X211018350. doi: 10.1177/2333794X211018350. eCollection 2021.
The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.
不良新生儿结局定义为存在出生窒息、呼吸窘迫、产伤、体温过低、胎粪吸入综合征、新生儿重症监护病房收治及新生儿死亡。在包括埃塞俄比亚在内的发展中国家，这是一个主要问题。本研究试图确定埃塞俄比亚东部选定公立医院不良新生儿结局的预测因素。2020年6月至10月，在埃塞俄比亚东部的三家公立医院开展了一项基于医院的前瞻性随访研究。共有2246名在这些医院分娩的妇女及新生儿纳入研究。通过访谈、观察清单及临床病历审查收集数据。报告以相对风险及95%置信区间呈现。不良新生儿结局的总体发生率为20.97%（95%置信区间：19.33 - 22.71%）。剖宫产出生的婴儿发生率为24.3%（95%置信区间：21.3%，27.5）。羊水胎粪的存在增加了剖宫产分娩新生儿的风险（归因风险比，1.52；95%置信区间：1.04，2.22）。在经阴道分娩的新生儿中，初产妇（归因风险比，1.42；95%置信区间：1.02，1.99）以及入院时诊断为产程异常或妊娠异常（如产前出血、子痫前期、产程梗阻、胎儿窘迫及胎位异常）的妇女所生新生儿发生不良新生儿结局的风险更高（归因风险比，1.30；95%置信区间：1.01，1.67）。剖宫产出生的婴儿发生不良新生儿结局的风险高于经阴道分娩的婴儿。产程异常或妊娠异常以及初产增加了阴道分娩时不良新生儿结局的风险。
