Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
BMC Pregnancy Childbirth. 2021 Jun 9;21(1):422. doi: 10.1186/s12884-021-03894-3.
The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors.
A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.
One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07-9.84) and no formal education (aOR 2.16; 95% CI 1.12-4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32-0.86) and caesarean section (aOR 0.44; 95% CI 0.19-0.99) had negative associations with NNM.
Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.
新生儿死亡率虽然有所下降，但低于婴儿死亡率，仍是中低收入国家面临的主要公共卫生挑战。迫切需要关注新生儿护理，尤其是在出生后 24 小时内和新生儿早期。新生儿近死产（NNM）是一个新兴概念，类似于产妇近死产。NNM 事件的发生频率比新生儿死亡高 3 至 8 倍。本研究旨在确定 NNM 的流行率并确定其相关因素。
这是一项在尼泊尔莫朗地区科希医院进行的基于医院的横断面研究。研究纳入了未指定产妇年龄和胎龄的新生儿及其母亲。主要纳入标准是 NNM 的实用和管理标志物，以及科希医院新生儿重症监护病房（NICU）收治的新生儿。不包括非尼泊尔公民。使用连续抽样方法，直到达到 1000 名新生儿的所需样本量。使用 SPSS® 版本 24.0 进行简单和多元逻辑回归。
共招募了 1000 名受访者。NNM 的患病率为每 1000 例活产 79 例。严重产妇发病率（调整后的优势比（aOR）4.52；95%置信区间（CI）2.07-9.84）和未接受正规教育（aOR 2.16；95% CI 1.12-4.14）与 NNM 呈正相关，而多胎产（aOR 0.52；95% CI 0.32-0.86）和剖宫产（aOR 0.44；95% CI 0.19-0.99）与 NNM 呈负相关。
产妇特征和并发症与 NNM 相关。医疗保健提供者应意识到产科因素对新生儿健康的影响，并为孕妇提供更早的干预措施，从而增加新生儿的生存机会。
