西岸地区分娩时记录的孕周与使用电子母婴健康登记处产前护理数据进行的孕周估计对比：一项比较分析。

Gestational age recorded at delivery versus estimations using antenatal care data from the Electronic Maternal and Child Health Registry in the West Bank: a comparative analysis.

作者信息

Isbeih Mervett, Venkateswaran Mahima, Abbas Eatimad, Abu-Khader Khadija, Awwad Tamara, Baniode Mohammad, Ghanem Buthaina, Hijaz Taghreed, Ramlawi Asad, Salman Rand, White Richard, Frøen J Frederik

机构信息

Palestinian National Institute of Public Health, WHO, Ramallah, occupied Palestinian territory.

Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway; Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway.

出版信息

Lancet. 2021 Jul;398 Suppl 1:S31. doi: 10.1016/S0140-6736(21)01517-8.

DOI:10.1016/S0140-6736(21)01517-8

PMID:34227964

Abstract

BACKGROUND

Estimated dates of delivery have important consequences for clinical decisions during pregnancy and labour. The Electronic Maternal and Child Health Registry (MCH eRegistry) in Palestine includes antenatal care data and birth data from hospitals. Our objective was to compare computed best estimates of gestational age in the MCH eRegistry with the gestational ages recorded by health-care providers in hospital delivery units.

METHODS

We obtained data for pregnant women in the West Bank registered in the MCH eRegistry from Jan 1, 2017 to March 31, 2017. Best estimates of gestational age in the registry are automated and based on a standard pregnancy duration of 280 days and ultrasound-based pregnancy dating before 20 weeks' gestation or the woman's last menstrual period date. Hospital recorded gestational ages are reported by care providers in delivery units and are rounded to the nearest week. We calculated proportions of gestational ages (with 95% CIs) from both sources that fell into the categories of term, very preterm (24-32 weeks' gestation), preterm (33-37 weeks), or post-term (>42 weeks).

FINDINGS

1924 women were included in the study. The median hospital recorded gestational age was 39 weeks (IQR 38-40 weeks) and according to MCH eRegistry estimates was 39 weeks and 5 days (IQR 38 weeks and 1 day to 40 weeks and 5 days). Proportions of very preterm, preterm, and post-term deliveries were higher based on MCH eRegistry estimates than on hospital recorded gestational ages (very preterm 3%, 95% CI 2-4 vs 2%, 1-2; preterm 6%, 5-7 vs 5%, 3-6 ; post-term 6%, 5-7 vs 1%, 1-2).

INTERPRETATION

In addition to clinical care, the proportions of term, very preterm, preterm, and post-term births can have implications for public health monitoring. The proportion of deliveries within the normal range of term gestation was calculated to be higher by care providers in delivery units than by MCH eRegistry estimates. Extending the access of hospitals to information from antenatal care in the MCH e-Registry could improve continuity of data and better care for pregnant women.

FUNDING

European Research Council, Research Council of Norway.

摘要

背景

预计分娩日期对孕期和分娩期间的临床决策具有重要影响。巴勒斯坦的电子妇幼健康登记处（妇幼健康电子登记处）包含来自医院的产前护理数据和出生数据。我们的目标是比较妇幼健康电子登记处计算得出的最佳孕周估计值与医院分娩单位医护人员记录的孕周。

方法

我们获取了2017年1月1日至2017年3月31日在西岸妇幼健康电子登记处登记的孕妇数据。登记处的最佳孕周估计值是自动生成的，基于280天的标准孕期以及妊娠20周前基于超声的孕周推算或孕妇的末次月经日期。医院记录的孕周由分娩单位的医护人员上报，并四舍五入到最接近的周数。我们计算了来自这两个来源的孕周（95%置信区间）在足月、极早产（妊娠24 - 32周）、早产（妊娠33 - 37周）或过期产（>42周）类别中的比例。

结果

1924名女性纳入研究。医院记录的孕周中位数为39周（四分位间距38 - 40周），根据妇幼健康电子登记处的估计为39周零5天（四分位间距38周零1天至40周零5天）。基于妇幼健康电子登记处的估计，极早产、早产和过期产的比例高于医院记录的孕周（极早产3%，95%置信区间2 - 4 vs 2%，1 - 2；早产6%，5 - 7 vs 5%，3 - 6；过期产6%，5 - 7 vs 1%，1 - 2）。