埃塞俄比亚东部公立医院新生儿濒临死亡情况的严重程度：一项横断面研究。
Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study.
作者信息
Tola Melese Adugna, Semahegn Agumasie, Tiruye Getahun, Tura Abera Kenay
机构信息
Department of Midwifery, College of Health Sciences, Mettu University, Mettu, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
出版信息
SAGE Open Med. 2022 Jul 9;10:20503121221108926. doi: 10.1177/20503121221108926. eCollection 2022.
OBJECTIVES
Although neonatal near miss is an emerging concept and a tool for improving neonatal care, its magnitude and associated factors are less researched in Ethiopia. Thus, this study was aimed to uncover the magnitude of neonatal near miss and its associated factors in public hospitals in Eastern Ethiopia.
METHODS
A facility-based cross-sectional study was employed on a randomly selected 405 mother-neonate pairs. An interview using a structured questionnaire accompanied by review of medical records was used to collect data from the mothers and records of the neonates. Neonatal near miss was defined as having any of the pragmatic (gestational age < 33 weeks, birth weight < 1750 g, and fifth minutes Apgar score < 7) or management criteria. Crude and adjusted logistic regression analysis was done to identify associated factors and presented with adjusted odds ratio with 95% confidence interval.
RESULTS
Of 401 mother-neonate pairs included in the study, 126 (31.4%, 95% confidence interval = [26.9, 36.2]) neonates had at least one neonatal near miss event at discharge. Neonatal near miss was more likely among neonates from referred women (adjusted odds ratio = 2.24, 95% confidence interval = [1.25, 4.03]), no antenatal care (adjusted odds ratio = 2.08, 95% confidence interval = [1.10, 3.93]), antepartum hemorrhage (adjusted odds ratio = 4.29, 95% confidence interval = [2.16, 8.53]), premature rupture of membrane (adjusted odds ratio = 4.07, 95% confidence interval = [2.05, 8.07]), obstructed labor (adjusted odds ratio = 2.61, 95% confidence interval = [1.23, 5.52]), non-vertex presentation (adjusted odds ratio = 3.03, 95% confidence interval = [1.54, 5.95]), and primiparous (adjusted odd ratio = 2.67, 95% confidence interval = [1.49, 4.77]).
CONCLUSIONS
In this study, we found that neonatal near miss is higher than previous findings in Ethiopia. Improving neonatal near miss requires promoting antenatal care, maternal referral system, and early identification and management of obstetric complications.
目的
尽管新生儿濒临死亡是一个新兴概念且是改善新生儿护理的一种工具，但在埃塞俄比亚，对其发生率及相关因素的研究较少。因此，本研究旨在揭示埃塞俄比亚东部公立医院中新生儿濒临死亡的发生率及其相关因素。
方法
采用基于机构的横断面研究，随机选取405对母婴。通过使用结构化问卷进行访谈并查阅病历，从母亲和新生儿记录中收集数据。新生儿濒临死亡被定义为符合任何实用标准（胎龄<33周、出生体重<1750克、5分钟阿氏评分<7）或管理标准。进行了粗逻辑回归分析和调整逻辑回归分析以确定相关因素，并给出调整后的比值比及95%置信区间。
结果
在纳入研究的401对母婴中，126名（31.4%，95%置信区间=[26.9, 36.2]）新生儿在出院时至少发生过一次新生儿濒临死亡事件。转诊产妇的新生儿发生新生儿濒临死亡的可能性更高（调整后的比值比= 2.24，95%置信区间=[1.25, 4.03]），未接受产前检查的新生儿（调整后的比值比= 2.08，95%置信区间=[1.10, 3.93]），产前出血（调整后的比值比= 4.29，95%置信区间=[2.16, 8.53]），胎膜早破（调整后的比值比= 4.07，95%置信区间=[2.05, 8.07]），产程梗阻（调整后的比值比= 2.61，95%置信区间=[1.23, 5.52]），胎位异常（调整后的比值比= 3.03，95%置信区间=[1.54, 5.95]），以及初产妇（调整后的比值比= 2.67，95%置信区间=[1.49, 4.77]）。
结论
在本研究中，我们发现新生儿濒临死亡的发生率高于埃塞俄比亚此前的研究结果。改善新生儿濒临死亡状况需要促进产前检查、孕产妇转诊系统以及产科并发症的早期识别和管理。
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