尼日利亚单一中心低资源环境下产程梗阻的新兴预测因素

Emerging Predictors of Obstructed Labour in a Single Nigerian Centre Population of a Low Resource Setting.

作者信息

Oguejiofor Charlotte B, Ezugwu Chinedu J, Eleje George U, Emeka Ekene A, Akabuike Josephat C, Umeobika Joseph C, Ogelle Onyecherelam M, Umeononihu Osita S, Eke Ahizechukwu C

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.

Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, P.M.B. 5025, Nnewi, Nigeria.

出版信息

Trends Med Res. 2022;17(4):136-144. Epub 2022 Oct 1.

PMID:36281306

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9588426/

Abstract

BACKGROUND AND OBJECTIVE

Despite the stigma attached to obstructed labour in Nigeria, it has remained largely uninvestigated. Study determined the prevalence, emerging predictors, management modalities and complications of obstructed labour, compare them with cases without obstructed labour who delivered within the same period.

MATERIALS AND METHODS

A retrospective study and case-controlled analysis of obstructed labour managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria were undertaken. One control per case was randomly selected from the remaining births by selecting the non-obstructed labour cases. Bivariate analysis was performed by the Chi-squared test and conditional logistic regression analysis was used to determine variables associated with obstructed labour. Statistical significance was accepted when the p<0.05.

RESULTS

Of all the 5,301 deliveries during the study period, 80 cases of obstructed labour were recorded, giving a prevalence of 1.5%. Only 73 case files were available with complete information for the study's further analysis. A conditional logistic regression analysis, the risk factors were teenage pregnancy (p<0.001, Adjusted Odds Ratio (AOR):5.43, 95% Confidence Interval (CI):1.20-8.05), unbooked status (p<0.001, AOR:0.01, 95%CI:0.00-0.02), nulliparity (p<0.001, AOR:4.15, 95%CI:2.42-7.25), short stature (p<0.001, AOR:44.74, 95%CI:19.51-113.53) and birth weight (p<0.001, AOR:4.52, 95%CI:2.69-7.71). The case fatality rate was 5.5% and the perinatal mortality rate was 21.9%.

CONCLUSION

Majority obstructed labour have high maternal morbidity and perinatal mortality.

摘要

背景与目的

尽管尼日利亚存在难产相关的污名，但该问题在很大程度上仍未得到充分研究。本研究旨在确定难产的患病率、新出现的预测因素、管理方式及并发症，并将其与同期分娩的非难产病例进行比较。

材料与方法

对尼日利亚东南部Nnewi的Nnamdi Azikiwe大学教学医院处理的难产病例进行回顾性研究及病例对照分析。从其余分娩病例中为每个病例随机选择一个对照，即选择非难产病例。采用卡方检验进行双变量分析，并使用条件逻辑回归分析来确定与难产相关的变量。当p<0.05时，认为具有统计学意义。

结果

在研究期间的5301例分娩中，记录到80例难产病例，患病率为1.5%。仅有73份病例档案有完整信息可供本研究进一步分析。条件逻辑回归分析显示，危险因素包括青少年妊娠（p<0.001，调整优势比（AOR）：5.43，9%置信区间（CI）：1.20 - 8.05）、未登记状态（p<0.001，AOR：0.01，95%CI：0.00 - 0.02）、初产（p<0.001，AOR：4.15，95%CI：2.42 - 7.25）、身材矮小（p<0.001，AOR：44.74，95%CI：19.51 - 113.53）和出生体重（p<0.001，AOR：4.52，95%CI：2.69 - 7.71）。病死率为5.5%，围产儿死亡率为21.9%。