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2020 年,在埃塞俄比亚西北戈贾姆地区医院分娩的妇女中,即时产后贫血的严重程度及其相关因素。

The magnitude and associated factors of immediate postpartum anemia among women who gave birth in east Gojjam zone hospitals, northwest- Ethiopia, 2020.

机构信息

Department of Midwifery, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia.

Departments of Midwifery, Debre Markos University, Debre Markos, Ethiopia.

出版信息

PLoS One. 2023 Mar 15;18(3):e0282819. doi: 10.1371/journal.pone.0282819. eCollection 2023.

Abstract

BACKGROUND

Globally around half a million maternal death occurred annually related to labor and delivery of which twenty percent is contributed by post-partum anemia. Postpartum anemia contributes about two percent of total maternal mortality in Ethiopia. Immediate postpartum anemia is a common public health problem in most parts of the globe, being frequent in low and middle-income countries including in the developed world. The previous studies cut off point for immediate postpartum Anemia is 11mg/dl which is the cutoff point of anemia after one week of postpartum, environmental factors like barefoot were not addressed in the previous studies and the previous studies were conducted in a single facility This study aimed to assess the magnitude and associated factors of immediate post-partum anemia among women who gave birth in East Gojjam zone hospitals, Northwest Ethiopia.

METHODS

Institutional based cross-sectional study was conducted from October 20-November 20 2020 on immediate post-partum anemia. During the study 467 study participants were included by using systematic random sampling method Data were collected using a structured interviewer-administered questionnaire and a blood sample was used for hemoglobin determination. Data were checked, coded, and entered into Epi-Data Version 4.2 and then exported to SPSS version 25 for analysis. Binary logistic regressions were done to identify predictors of immediate post-partum anemia and a 95% confidence interval of odds ratio at a p-value less than was taken as a significance level.

RESULTS

The overall magnitude of immediate postpartum anemia among mothers who gave birth in East Gojjam Zone Hospitals were found to be 21.63% (95% CI:18.12%, 25.11%), not having antenatal care follow-up (Adjusted Odds Ratio (AOR) = 2.92;95% CI:1.20,7.06), assisted instrumental delivery (AOR = 2.72; 95% CI:1.08,6.78),mid-upper arm circumferences less than 23cm (AOR = 5.75;95% CI:3.38, 9.79), antepartum hemorrhage (AOR = 4.51; 95% CI:2.42, 8.37), never wearing shoes (AOR = 2.60; 95% CI:1.10, 6.14) were found to be significantly associated with immediate postpartum anemia.

CONCLUSION

This study indicates that immediate postpartum anemia is a moderate public health problem in the study area. A more careful strategy is ideal to increase antenatal care follow-up that sticks to national guideline contact schedule, safe reduction of instrumental and cesarean deliveries to the minimum, quick and timely linkage and treatment of malnourished pregnant mothers to the center where they get adequate health care services, along with a high index of suspicion in mothers diagnosed with antepartum hemorrhage, wise and vigilant advice on consistent use of the shoe for pregnant mothers are recommended to tackle the burden of immediate post-partum anemia.

摘要

背景

全球每年约有 50 万例与分娩相关的孕产妇死亡,其中 20%是产后贫血导致的。产后贫血导致埃塞俄比亚总孕产妇死亡率的 2%。即刻产后贫血是全球大多数地区常见的公共卫生问题,在包括发达国家在内的中低收入国家中较为常见。之前的研究中,即刻产后贫血的截止点为 11mg/dl,这是产后一周后贫血的截止点,而之前的研究没有考虑到赤脚等环境因素,并且之前的研究仅在单一机构进行。本研究旨在评估东戈贾姆地区医院分娩的妇女即刻产后贫血的程度及其相关因素。

方法

2020 年 10 月 20 日至 11 月 20 日,采用基于机构的横断面研究方法,对即刻产后贫血进行研究。在研究期间,采用系统随机抽样方法纳入了 467 名研究参与者。使用结构化访谈员管理的问卷收集数据,并采集血样进行血红蛋白测定。数据经过检查、编码并输入 Epi-Data 版本 4.2,然后导出到 SPSS 版本 25 进行分析。采用二元逻辑回归来确定即刻产后贫血的预测因素,并以 p 值小于 0.05 为显著性水平。

结果

研究发现,东戈贾姆地区医院分娩的母亲中即刻产后贫血的总体发生率为 21.63%(95%CI:18.12%,25.11%)。未进行产前保健随访(调整后的优势比(AOR)=2.92;95%CI:1.20,7.06)、辅助器械分娩(AOR=2.72;95%CI:1.08,6.78)、中上臂周长小于 23cm(AOR=5.75;95%CI:3.38,9.79)、产前出血(AOR=4.51;95%CI:2.42,8.37)、从不穿鞋(AOR=2.60;95%CI:1.10,6.14)与即刻产后贫血显著相关。

结论

本研究表明,即刻产后贫血是研究地区的一个中度公共卫生问题。需要制定更细致的策略,以增加产前保健随访,遵循国家指南规定的接触时间表,将器械和剖宫产分娩的比例降至最低,及时将营养不良的孕妇转诊到能够获得充分保健服务的中心,并对产前出血的母亲保持高度警惕,建议孕妇始终明智地穿着鞋子,以减轻即刻产后贫血的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65f3/10016639/f4c9f3c44274/pone.0282819.g001.jpg

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