在埃塞俄比亚西南部医疗中心分娩的妇女中不良围产结局的预测因素:一项回顾性队列研究。
Predictors of adverse perinatal outcome among women who gave birth at Medical Center of Southwest Ethiopia: a retrospective cohort study.
机构信息
Nursing, Mettu University, Mettu, Ethiopia
Public Health, Mettu University, Mettu, Ethiopia.
出版信息
BMJ Open. 2022 Mar 1;12(3):e053881. doi: 10.1136/bmjopen-2021-053881.
OBJECTIVES
The aim of this study was to determine predictors of adverse perinatal outcome among women who gave birth at Medical Center of Southwest Ethiopia.
SETTING
Institutional based retrospective cohort study was conducted among women who gave birth at Medical Center of Southwest Ethiopia.
PARTICIPANTS
Medical record of 777 women was included in the study by using maternity HMIS logbook as entry point. Simple random sampling technique without replacement was employed to select individual medical record using computer generated random numbers.
PRIMARY OUTCOME MEASURED
Predictors of adverse perinatal outcome were examined using modified Poisson regression with a robust SE.
RESULTS
Majority, 74.1% of the participants were in the age group of 21-34 years and the median age was 26 (IQR=7) years. More than one-third, 35.9% of the mothers were primigravida and only 21.2% of them had above four antenatal cares (ANC) visit. The overall incidence of adverse perinatal outcome was 31.5% (95% CI: 28.3 to 34.9). Maternal age less than 20 years (adjusted risk ratio, aRR=1.3; 95% CI: 1.01 to 1.5), rural residence (aRR=1.27; 95% CI: 1.04 to 1.59), presence of antepartum haemorrhage in current pregnancy (aRR=1.7; 95% CI: 1.38 to 2.07), maternal anaemia (aRR=1.25; 95% CI: 1.03 to 1.53), lack of ANC visit (aRR=2.29; 95% CI: 1.35 to 3.90), induced labour (aRR=1.77; 95% CI: 1.43 to 2.19) and being positive for venereal disease research laboratory (VDRL) test in current pregnancy (aRR=2.0; 95% CI: 1.16 to 3.38) were found to be significantly associated with adverse perinatal outcome.
CONCLUSION
The incidence of adverse perinatal outcome in the study area is high and maternal age less than 20, rural residency, maternal anaemia, antepartum haemorrhage in the current pregnancy, inadequate ANC visit, induction of labour and being positive for VDRL test were found to predict occurrence of adverse perinatal outcome. Majority of these problems can be managed by providing quality antenatal, intrapartum and post-natal care.
目的
本研究旨在确定在埃塞俄比亚西南部医疗中心分娩的妇女中不良围产结局的预测因素。
背景
在埃塞俄比亚西南部医疗中心进行了基于机构的回顾性队列研究。
参与者
本研究纳入了 777 名妇女的医疗记录,以产妇 HMIS 日志作为切入点。使用计算机生成的随机数,采用简单随机抽样技术,不进行替换,选择个体医疗记录。
主要结局测量
使用具有稳健 SE 的修正泊松回归来检查不良围产结局的预测因素。
结果
大多数参与者(74.1%)年龄在 21-34 岁之间,中位数年龄为 26(IQR=7)岁。超过三分之一(35.9%)的母亲是初产妇,只有 21.2%的人接受了 4 次以上的产前保健(ANC)检查。不良围产结局的总发生率为 31.5%(95%CI:28.3-34.9)。母亲年龄小于 20 岁(调整后的风险比,aRR=1.3;95%CI:1.01-1.5)、农村居住(aRR=1.27;95%CI:1.04-1.59)、当前妊娠时出现产前出血(aRR=1.7;95%CI:1.38-2.07)、母亲贫血(aRR=1.25;95%CI:1.03-1.53)、缺乏 ANC 检查(aRR=2.29;95%CI:1.35-3.90)、引产(aRR=1.77;95%CI:1.43-2.19)和当前妊娠时梅毒血清学研究实验室(VDRL)检查阳性(aRR=2.0;95%CI:1.16-3.38)与不良围产结局显著相关。
结论
该地区不良围产结局的发生率较高,母亲年龄小于 20 岁、农村居住、母亲贫血、当前妊娠时产前出血、ANC 检查不足、引产和 VDRL 检查阳性被认为是不良围产结局发生的预测因素。这些问题中的大多数可以通过提供优质的产前、分娩和产后护理来解决。