埃塞俄比亚德布雷贝汉转诊医院新生儿出生窒息的决定因素：病例对照研究。
Determinants of birth asphyxia among newborns in Debre Berhan referral hospital, Debre Berhan, Ethiopia: a case-control study.
机构信息
Asrat Woldeyus Health Science Campus, School of Public Health, Debre Berhan University, Debre Berhan, Ethiopia.
Asrat Woldeyus Health Science Campus, School of Nursing and Midwifery, Debre Berhan University, Debre Berhan, Ethiopia.
出版信息
BMC Pediatr. 2022 Mar 30;22(1):165. doi: 10.1186/s12887-022-03223-3.
BACKGROUND
Birth asphyxia is the major public health problem in the world. It is estimated that around 23% of all newborn deaths are caused by birth asphyxia worldwide. Birth asphyxia is the top three causes of newborn deaths in sub-Saharan Africa and more than one-third of deaths in Ethiopia. Therefore, the aim of this study was to identify determinants of birth asphyxia which can play a crucial role to decrease the death of newborns.
METHODS
Unmatched case-control study design was implemented among 276 (92 cases and 184 controls) newborns from January 1st to March 30th, 2020. A systematic sampling technique was used to select the study participants. Data were collected by using a semi-structured interviewer-administered questionnaire and document review by trained nurses and midwives who work at the delivery ward of the hospitals. Bivariate logistic regression analysis was done to identify determinants of birth asphyxia. Adjusted odds ratios with 95% confidence intervals and p-value less than and equal to 0.05 were used to assess the level of significance.
RESULTS
In this study, maternal education of being can't read & write [AOR = 4.7, 95% CI: (1.2, 11.9)], ante-partum hemorrhage [AOR = 7.7, 95% CI: (1.5, 18.5)], prolonged labor [AOR =13.5, 95% CI: (2.0, 19.4)], meconium stained amniotic fluid [AOR = 11.3, 95% CI: (2.7, 39.5)], breech fetal presentation [AOR = 4.5, 95% CI: (2.0, 8.4)] and preterm birth [AOR: 4.1, 95% CI: (1.8, 9.2)] were factors which showed significantly associated with birth asphyxia among newborns.
CONCLUSIONS
In this study, maternal education can't read & write, antepartum hemorrhage, prolonged labor, stained amniotic fluid, breech fetal presentation, preterm birth were significantly associated with birth asphyxia. So, educating mothers to enhance health-seeking behaviors and close monitoring of the labor and fetus presentation were recommended to reduce birth asphyxia.
背景
出生窒息是全球主要的公共卫生问题。据估计，全球约有 23%的新生儿死亡是由出生窒息引起的。在撒哈拉以南非洲，出生窒息是导致新生儿死亡的前三大原因之一，在埃塞俄比亚，超过三分之一的新生儿死亡是由出生窒息引起的。因此，本研究旨在确定出生窒息的决定因素，这些因素对于降低新生儿死亡人数至关重要。
方法
本研究采用了 276 名（92 例病例和 184 例对照）新生儿的病例对照研究设计，时间为 2020 年 1 月 1 日至 3 月 30 日。采用系统抽样技术选择研究对象。数据由经过培训的护士和助产士使用半结构式访谈式问卷和文件审查收集，这些护士和助产士在医院的分娩病房工作。采用双变量逻辑回归分析来确定出生窒息的决定因素。使用调整后的优势比（95%置信区间和 p 值小于或等于 0.05）来评估显著性水平。
结果
在这项研究中，母亲不能读写的教育程度[比值比（AOR）= 4.7，95%置信区间（CI）：（1.2，11.9）]、产前出血[AOR = 7.7，95%CI：（1.5，18.5）]、产程延长[AOR = 13.5，95%CI：（2.0，19.4）]、胎粪污染羊水[AOR = 11.3，95%CI：（2.7，39.5）]、臀位胎儿[AOR = 4.5，95%CI：（2.0，8.4）]和早产[AOR：4.1，95%CI：（1.8，9.2）]是与新生儿出生窒息显著相关的因素。
结论
在这项研究中，母亲不能读写的教育程度、产前出血、产程延长、羊水胎粪污染、臀位胎儿、早产与出生窒息显著相关。因此，建议通过教育母亲来增强寻求医疗保健的行为，并密切监测分娩和胎儿情况，以减少出生窒息的发生。
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