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加纳首次产前保健就诊的孕妇的临床和实验室表现:一项基于医院的研究。

Clinical and laboratory presentation of first-time antenatal care visits of pregnant women in Ghana, a hospital-based study.

机构信息

Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.

Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, United States of America.

出版信息

PLoS One. 2023 Jan 4;18(1):e0280031. doi: 10.1371/journal.pone.0280031. eCollection 2023.

Abstract

BACKGROUND

The WHO recommends pregnant women attend antenatal clinic at least three times during pregnancy; during the first, second and third trimesters. During these visits, an array of clinical and laboratory tests is conducted. The information obtained plays an important role not only in the management and care of pregnancy, but also guides policies targeted at addressing pregnancy-induced health challenges. This study therefore presents laboratory and clinical information of pregnant women at their first antenatal visits.

METHODS

The study was cross-sectional in design which retrospectively reviewed laboratory and clinical data of pregnant women attending their first antenatal clinic (ANC) at the Comboni Hospital, Volta region, Ghana. The data reviewed included information on hemoglobin level, hemoglobin phenotype, malaria diagnostics, Human Immunodeficiency Virus test (HIV), glucose-6-phosphate dehydrogenase (G6PD) deficiency, Hepatitis C Virus (HCV) test, Hepatitis B Virus (HBV) test, Syphilis test, blood pressure, age, urine glucose, and urine protein. The hemoglobin level was assayed with a hemoglobinometer. Qualitative lateral flow chromatographic immunoassay techniques were used to diagnose the HIV, HCV, HBV, syphilis, and malaria status of the pregnant women. Urine dipstick was used assay for the urine protein and urine glucose, whilst the methemoglobin test was used for the G6PD deficiency and alkaline hemoglobin electrophoresis for hemoglobin phenotype. Data on demographic, anthropometric and vital signs such as age, weight and blood pressure were also collected. Descriptive statistics were performed. Frequency and percentages were used to describe the categorical variables and means and standard deviations used to describe the continuous variables.

RESULTS

Hemoglobin S(Hb S) was found in 12.8% of the women with 73.4% having hemoglobin levels below 11.5g/dl. On G6PD deficiency, 1.6% and 0.8% were partially and fully defective respectively. Also, urine protein (1.2%) and glucose (0.4%) were detected. The prevalence of HBV, HCV and malaria were 4.4%, 3.6% and 2.4%, respectively.

CONCLUSION

Anemia in pregnancy was high among the study sample. Malaria and hepatitis infections were observed in the study sample. Policies on maternal health should be targeted at providing better nutritional options, that can enhance the hemoglobin level during pregnancy. Pregnant women should benefit from enhanced surveillance for HIV, HBV, HCV, and syphilis.

摘要

背景

世界卫生组织建议孕妇在怀孕期间至少进行三次产前检查;分别在怀孕初期、中期和晚期。在此期间,会进行一系列临床和实验室检查。这些检查获取的信息不仅对妊娠管理和护理非常重要,还为解决妊娠相关健康挑战的政策提供了指导。本研究因此呈现了孕妇在首次产前检查时的实验室和临床信息。

方法

这是一项回顾性的横断面研究,对加纳沃尔特地区孔博尼医院首次产前就诊的孕妇的实验室和临床数据进行了回顾性分析。审查的数据包括血红蛋白水平、血红蛋白表型、疟疾诊断、人类免疫缺陷病毒检测(HIV)、葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症、丙型肝炎病毒(HCV)检测、乙型肝炎病毒(HBV)检测、梅毒检测、血压、年龄、尿葡萄糖和尿蛋白。血红蛋白水平通过血红蛋白计进行检测。采用定性侧向流动色谱免疫分析技术检测孕妇的 HIV、HCV、HBV、梅毒和疟疾状态。尿试纸用于检测尿蛋白和尿葡萄糖,而高铁血红蛋白试验用于检测 G6PD 缺乏症,碱性血红蛋白电泳用于检测血红蛋白表型。还收集了人口统计学、人体测量学和生命体征(如年龄、体重和血压)的数据。进行了描述性统计。使用频率和百分比描述分类变量,使用平均值和标准差描述连续变量。

结果

研究中 12.8%的女性携带血红蛋白 S(Hb S),其中 73.4%的女性血红蛋白水平低于 11.5g/dl。G6PD 缺乏症中,部分和完全缺陷的分别占 1.6%和 0.8%。此外,还检测到尿蛋白(1.2%)和尿葡萄糖(0.4%)。HBV、HCV 和疟疾的患病率分别为 4.4%、3.6%和 2.4%。

结论

研究样本中妊娠贫血发生率较高。研究样本中观察到疟疾和肝炎感染。孕产妇健康政策应侧重于提供更好的营养选择,以提高妊娠期间的血红蛋白水平。孕妇应受益于加强对 HIV、HBV、HCV 和梅毒的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68a2/9812315/4c5e6f046475/pone.0280031.g001.jpg

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