Chicumbe Sérgio, Martins Maria do Rosário Oliveira
Health System and Policy Program, Instituto Nacional de Saúde, Estrada Nacional 1, Vila de Marracuene CEP 0205-02, Maputo 1120, Mozambique.
Group for Performance in Obstetrics and Evaluation of Maternities (POEM), Instituto Nacional de Saúde, Estrada Nacional 1, Vila de Marracuene CEP 0205-02, Maputo 1120, Mozambique.
Healthcare (Basel). 2022 May 31;10(6):1013. doi: 10.3390/healthcare10061013.
Information about factors underlying peripartum complications is needed to inform health programs in Mozambique. This retrospective study covered the period from January 2013 to December 2018 and was performed at three rural-district hospitals in southern Mozambique, aiming at assessing factors associated with caesarean and peripartum complications. Data were extracted by clinical criteria-based audits on randomly select clients' files. Logistical regression was used to identify factors associated with peripartum complications. Amongst 5068 audited files, women mean age was 25 years (Standard Deviation (SD) = 7), gestational age was 38 weeks (SD = 2), 25% had "high obstetric-risk" and 19% delivered by caesarean. Factors significantly associated with caesarean included being transferred [Adjusted Odds Ratio (aOR) =1.8; 95% Confidence Interval (95%CI) = 1.3-2.6], preeclampsia [aOR (95%CI) = 2.0 (1.2-3.3)], age [aOR (95%CI) = 0.96 (0.93-0.99)] and "high obstetric-risk" [aOR (95%CI) = 0.54 (0.37-0.78)]. Factors significantly associated with neonatal complication included mother being transferred [aOR (95%CI) = 2.1 (1.8-2.6)], "high obstetric-risk" [aOR (95%CI) = 1.6 (1.3-1.96)], preeclampsia [aOR (95%CI) = 1.5 (1.2-1.8), mother's age [aOR (95%CI) = -2% (-3%, -0.1%)] and gestational age [aOR (95%CI) = -8% (-13%, -6%)] increment. This study identified amendable factors associated with peripartum complications in rural referral health settings. Strengthening hospitals' performance assurance is critical to address the identified factors and improve peripartum outcomes for mothers-neonate dyads.
需要了解围产期并发症背后的因素，以便为莫桑比克的卫生项目提供信息。这项回顾性研究涵盖了2013年1月至2018年12月期间，在莫桑比克南部的三家农村地区医院进行，旨在评估与剖宫产和围产期并发症相关的因素。通过基于临床标准的审核从随机选择的客户档案中提取数据。采用逻辑回归来确定与围产期并发症相关的因素。在5068份审核档案中，女性平均年龄为25岁（标准差（SD）=7），孕周为38周（SD=2），25%有“高产科风险”，19%为剖宫产。与剖宫产显著相关的因素包括被转诊[调整优势比（aOR）=1.8；95%置信区间（95%CI）=1.3 - 2.6]、子痫前期[aOR（95%CI）=2.0（1.2 - 3.3）]、年龄[aOR（95%CI）=0.96（0.93 - 0.99）]和“高产科风险”[aOR（95%CI）=0.54（0.37 - 0.78）]。与新生儿并发症显著相关的因素包括母亲被转诊[aOR（95%CI）=2.1（1.8 - 2.6）]、“高产科风险”[aOR（95%CI）=1.6（1.3 - 1.96）]、子痫前期[aOR（95%CI）=1.5（1.2 - 1.8）]、母亲年龄[aOR（95%CI）=-2%（-3%，-0.1%）]和孕周增加[aOR（95%CI）=-8%（-13%，-6%）]。本研究确定了农村转诊医疗机构中与围产期并发症相关的可改进因素。加强医院的绩效保证对于解决所确定的因素和改善母婴二元组的围产期结局至关重要。
