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埃塞俄比亚南部哈瓦萨大学综合专科医院剖宫产分娩女性的剖宫产术后恢复时间:一项前瞻性队列研究。

Time-to-recovery after cesarean section delivery among women who gave birth through cesarean section at Hawassa University Comprehensive Specialized Hospital, South Ethiopia: A prospective cohort study.

作者信息

Fikrie Anteneh, Zeleke Rahel, Bekele Henok, Seyoum Wongelawit, Hailu Dejene, Wayessa Zelalem Jabessa, Tufa Girma, Utura Takala, Matie Male, Oda Gebeyehu Dejene

机构信息

School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Southeastern Ethiopia.

Departement of Public Health, Pharma College Hawassa Campus, Hawassa, Ethiopia.

出版信息

PLOS Glob Public Health. 2022 Oct 5;2(10):e0000696. doi: 10.1371/journal.pgph.0000696. eCollection 2022.

Abstract

Cesarean deliveries have become a major public health problem worldwide in recent decades. In addition, information on the quality of service, as measured by timely recovery is scarce. This study was assessed predictors of recovery time after cesarean section among women who delivered by cesarean section at Hawassa University Comprehensive Specialized Hospital (HU-CSH) Southern Ethiopia. Institution-based prospective cohort study design was conducted among 381 study participants from July to August 2020. A consecutive sampling technique employed to select study participants. A pre-tested structured questionnaire was used to collect the data. The data were entered and analyzed by Epi info version 7 and SPSS respectively. Bivariable and multivariable Cox regression used to identify the predictors of time-to-recovery after cesearean section. Adjusted Hazard Ratio (AHR) with the respective 95% confidence intervals (CIs)and p-value <0.5 was used to declare statistical significance. A total of 369 mothers who undergone cesearean section were followed for 1,042 person-days of observation. The timely recovery (within 4 days) was found to be 96.2% [95%CI: 94.04-98.4%] and the overall median (IQR) time of recovery was 2.00 (2, 3) days. The study revaled that the Incidence density rate (IDR) of timely recovery was found to be 0.34 per person-days or 2.38 per person-week. Whereas, the cumulative probability of not recovered on the 1st and 4th day was 0.995 and 0.038 respectively. This study found that women who had ANC follow-up (AHR = 1.49, 95%, CI: 1.05-2.10) and discharge from the wound site (AHR = 0.13, 95%, CI: 0.03-0.56) were identified as a significant positive and negative predictors of time-to-recovery after CS delivery respectively. The rate of early recovery obtained by this study was comparable to the global level figures. Still, the cleanness of the surgical site to prevent the incidence of postsurgical site CS delivery is very essential.

摘要

近几十年来,剖宫产已成为全球范围内一个重大的公共卫生问题。此外,关于以及时恢复来衡量的服务质量的信息匮乏。本研究评估了在埃塞俄比亚南部哈瓦萨大学综合专科医院(HU-CSH)接受剖宫产的女性剖宫产后恢复时间的预测因素。2020年7月至8月,对381名研究参与者进行了基于机构的前瞻性队列研究设计。采用连续抽样技术选择研究参与者。使用经过预测试的结构化问卷收集数据。数据分别通过Epi info 7版本和SPSS录入并分析。采用双变量和多变量Cox回归来确定剖宫产后恢复时间的预测因素。使用调整后的风险比(AHR)及其各自的95%置信区间(CIs)和p值<0.5来判定统计学显著性。对总共369名接受剖宫产的母亲进行了1042人日的观察。发现及时恢复(4天内)的比例为96.2%[95%CI:94.04 - 98.4%],恢复的总体中位数(IQR)时间为2.00(2,3)天。研究发现,及时恢复的发病密度率(IDR)为每人日0.34或每人周2.38。而在第1天和第4天未恢复的累积概率分别为0.995和0.038。本研究发现,接受产前检查随访的女性(AHR = 1.49,95%,CI:1.05 - 2.10)和伤口部位拆线的女性(AHR = 0.13,95%,CI:0.03 - 0.56)分别被确定为剖宫产后恢复时间的显著正向和负向预测因素。本研究得出的早期恢复率与全球水平数据相当。尽管如此,保持手术部位清洁以预防剖宫产后手术部位感染的发生非常重要。

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