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在埃塞俄比亚中北部的北谢瓦地区公立卫生保健医院分娩的新生儿中,NNM 的严重程度及其相关因素:一项多水平分析。

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis.

机构信息

Department of Public Health, College of Health Sciences, Salale University, Fitche, Ethiopia.

出版信息

Front Public Health. 2022 Nov 7;10:979636. doi: 10.3389/fpubh.2022.979636. eCollection 2022.

Abstract

BACKGROUND

Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia.

METHODS

A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors.

RESULT

The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association.

CONCLUSION AND RECOMMENDATION

One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.

摘要

背景

新生儿濒死是指新生儿在生命的头 28 天内接近死亡但最终幸存下来的情况,这可能是偶然发生的,也可能是因为他们得到了高质量的护理。它被认为是一个主要的公共卫生问题,导致欠发达国家的疾病负担加重。每有一例新生儿濒死,就有许多其他新生儿出现严重并发症。尽管现实严峻,但在埃塞俄比亚,似乎存在对新生儿濒死的严重程度和预测因素的认识差距,此前的研究主要集中在新生儿死亡调查上。本研究旨在确定在埃塞俄比亚北谢瓦地区分娩的新生儿中新生儿濒死的严重程度及其决定因素。

方法

2021 年 1 月 30 日至 6 月 30 日,采用系统随机抽样技术,在北谢瓦地区公立医院对 747 名新分娩的婴儿进行了一项基于设施的横断面研究。利用世界卫生组织的标记标准确定新生儿濒死。收集的数据使用 EpiData 4.4.6 进行编码、录入和清理,并使用 SPSS 软件(版本 26)进行分析。采用描述性统计方法计算汇总统计量和比例。二变量分析中截断值为 0.25,多变量逻辑回归中截断值为 0.05 的变量用于识别预测因素。

结果

新生儿濒死的患病率为每 1000 例活产 35.3%(95%CI=31.9-38.6)。参与者的职业(AOR:0.55,CI:0.33-0.90)、婚姻状况(AOR:2.19;CI:1.06-4.51)、器械分娩(AOR:1.98;CI:1.10-3.55)、产时出血(AOR:2.27;CI:1.03-5.01)、流产史(AOR:1.59;CI:1.03-2.44)、胎位不正(AOR:1.77;CI:1.14-2.77)、胎膜早破(AOR:2.36;CI:1.59-3.51)和与妊娠相关的感染(AOR:1.99;CI:1.14-3.46)与统计学显著相关。

结论和建议

三分之一的新生儿面临严重的新生儿健康状况。鉴于此,通过在妊娠期间以及分娩期间和之后为母亲提供熟练和高质量的护理来解决可改变的产科风险因素,对于改善新生儿健康状况非常重要。此外,通过提供适当的服务和关于流产后果的咨询,加强产前保健服务以减少妊娠期间发生的感染,对于扭转这一问题至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7835/9676963/0ad201a8dc52/fpubh-10-979636-g0001.jpg

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