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在埃塞俄比亚阿姆哈拉地区的转诊医院中,早产儿低出生体重儿的发病和死亡模式:回顾性随访研究。

Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study.

机构信息

Department of Nursing, Mizan-Tepi University, Mizan, Ethiopia

School of Midwifery, Jimma University, Jimma, Oromia, Ethiopia.

出版信息

BMJ Open. 2022 Jul 8;12(7):e054574. doi: 10.1136/bmjopen-2021-054574.

Abstract

OBJECTIVE

This study aimed to assess the morbidity and mortality patterns of preterm neonates with low birth weight admitted in the Amhara region referral hospitals in Ethiopia.

DESIGN

Hospital-based retrospective follow-up study.

SETTING

Amhara region referral hospitals, Ethiopia.

PARTICIPANTS

A total of 291 preterm neonates low birth weight that were admitted to referral hospitals in the Amhara region between 1 January 2017 and 30 December 2018 were reviewed. Data were entered into Epi-data V.4.4.2.1 and exported to STATA V.14 for analysis, and variables with a p value of <0.05 at 95% confidence level in multivariable logistic regression model analysis were declared as statistically significant associated factors of mortality.

PRIMARY OUTCOME

Morbidity and mortality patterns in preterm low birthweight neonates.

RESULTS

This study revealed that 37.8% (95% CI 32.4% to 43.5%) of preterm low birthweight neonates died. The most common morbidities found were 219 (75.26%) hypothermia, followed by 201 (69.07%), 145 (49.83%), 39 (13.4%) and 24 (8.25%) with sepsis, respiratory distress, jaundice and congenital anomalies, respectively. Sepsis (AOR: 2.0; 95% CI 1.03 to 3.89), respiratory distress (AOR: 4.6; 95% CI 2.51 to 8.40), hypoglycaemia (AOR 3.91; 95% CI 1.09 to 10.52), APGAR score at fifth minute <7 (AOR 0.39; 95% CI (0.18 to 0.82) and duration of hospital stay below mean (<9.82 days) (AOR 0.17; 95% CI 0.09 to 0.33) were associated with mortality.

CONCLUSION

The mortality rate of preterm low birthweight neonates was high, indicating that this is a public health issue. Hypothermia, sepsis, respiratory distress, jaundice and congenital anomalies were the common morbidities. Sepsis, respiratory distress, hypoglycaemia, Apgar score at fifth minute <7 and duration of hospital stay below the mean were independent factors of mortality. However, these need to be further investigated in future research and appropriately addressed using prospective follow-up.

摘要

目的

本研究旨在评估埃塞俄比亚阿姆哈拉地区转诊医院收治的低出生体重早产儿的发病率和死亡率模式。

设计

基于医院的回顾性随访研究。

地点

阿姆哈拉地区转诊医院,埃塞俄比亚。

参与者

共有 291 名低出生体重早产儿于 2017 年 1 月 1 日至 2018 年 12 月 30 日期间在阿姆哈拉地区转诊医院住院,对其进行了回顾性研究。数据输入 Epi-data V.4.4.2.1 并导出到 STATA V.14 进行分析,在多变量逻辑回归模型分析中,p 值<0.05 的变量被宣布为与死亡率相关的统计学显著相关因素。

主要结果

低出生体重早产儿的发病率和死亡率模式。

结果

本研究显示,37.8%(95%CI 32.4%至 43.5%)的低出生体重早产儿死亡。最常见的并发症包括 219 例(75.26%)低体温,其次是 201 例(69.07%)、145 例(49.83%)、39 例(13.4%)和 24 例(8.25%)的败血症、呼吸窘迫、黄疸和先天性异常。败血症(AOR:2.0;95%CI 1.03 至 3.89)、呼吸窘迫(AOR:4.6;95%CI 2.51 至 8.40)、低血糖(AOR 3.91;95%CI 1.09 至 10.52)、第 5 分钟时 APGAR 评分<7(AOR 0.39;95%CI(0.18 至 0.82)和住院时间低于平均值(<9.82 天)(AOR 0.17;95%CI 0.09 至 0.33)与死亡率相关。

结论

低出生体重早产儿的死亡率很高,表明这是一个公共卫生问题。低体温、败血症、呼吸窘迫、黄疸和先天性异常是常见的并发症。败血症、呼吸窘迫、低血糖、第 5 分钟 APGAR 评分<7 和住院时间低于平均值是死亡的独立因素。然而,这些需要在未来的研究中进一步调查,并通过前瞻性随访进行适当处理。

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