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坦桑尼亚北部基督教学医中心足月产孕妇产后复发及相关因素的回顾性队列研究。

Recurrence of post-term pregnancy and associated factors among women who delivered at Kilimanjaro Christian Medical Centre in northern Tanzania: A retrospective cohort study.

机构信息

Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania.

Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

出版信息

PLoS One. 2023 Apr 4;18(4):e0282078. doi: 10.1371/journal.pone.0282078. eCollection 2023.

Abstract

BACKGROUND

Post-term pregnancy is a health problem of clinical importance and; tends to recur in subsequent pregnancies. Maternal age, height, and male fetal sex are risk factors associated with Post-term pregnancy. The study aimed to determine the recurrence risk of post-term pregnancy and associated factors among women delivered at KCMC referral hospital.

METHODOLOGY

This retrospective cohort study used KCMC zonal referral hospital medical birth registry cohort data for 43472 women delivered between 2000 and 2018. Data were analyzed using STATA version 15 software. Log-binomial regression with robust variance estimator determined the factors associated recurrence of post-term pregnancy adjusted for other factors.

RESULTS

A total of 43472 women were analyzed. The proportion of post-term pregnancy was 11.4%, and the recurrence was 14.8%. The recurrence risk of post-term pregnancy was increased when a woman had a history of previous post-term pregnancy (aRR: 1.75; 95%CI: 1.44, 2.11). Advanced maternal age, i.e., ≥35years (aRR: 0.80; 95%CI: 0.65, 0.99), having secondary and higher education (aRR: 0.8; 95%CI: 0.66, 0.97), and being employed (aRR: 0.68; 95%CI: 0.55, 0.84) decreased the recurrence risk of post-term pregnancy. Women with recurrence of post-term pregnancy had a higher risk of delivering newborns weighed ≥4000gm (aRR: 5.05; 95% CI: 2.80, 9.09).

CONCLUSION

Post-term pregnancy is associated with recurrence risk in subsequent pregnancies. A history of previous post-term pregnancy is associated risk factor and these women are at increased risk of delivering newborns weighed ≥4000gm. Clinical counselling of women at risk of post-term pregnancy and timely management is recommended to prevent adverse neonatal and maternal outcomes.

摘要

背景

过期妊娠是一个具有临床重要意义的健康问题,并且往往会在随后的妊娠中再次发生。产妇年龄、身高和男性胎儿性别是与过期妊娠相关的风险因素。本研究旨在确定在 KCMC 转诊医院分娩的妇女中过期妊娠的复发风险及其相关因素。

方法

这是一项使用 KCMC 区域转诊医院医疗出生登记队列数据的回顾性队列研究,纳入了 2000 年至 2018 年期间分娩的 43472 名妇女。数据使用 STATA 版本 15 软件进行分析。使用稳健方差估计的对数二项式回归确定与其他因素调整后的过期妊娠复发相关的因素。

结果

共分析了 43472 名妇女。过期妊娠的比例为 11.4%,复发率为 14.8%。当妇女有过期妊娠史时,过期妊娠的复发风险增加(ARR:1.75;95%CI:1.44,2.11)。高龄产妇,即≥35 岁(ARR:0.80;95%CI:0.65,0.99)、接受过中等或高等教育(ARR:0.8;95%CI:0.66,0.97)和就业(ARR:0.68;95%CI:0.55,0.84)降低了过期妊娠的复发风险。有过期妊娠复发史的妇女,新生儿体重≥4000 克的风险更高(ARR:5.05;95%CI:2.80,9.09)。

结论

过期妊娠与随后妊娠的复发风险相关。既往过期妊娠史是相关的危险因素,这些妇女分娩新生儿体重≥4000 克的风险增加。建议对有过期妊娠风险的妇女进行临床咨询,并及时管理,以预防不良的新生儿和产妇结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a89/10072474/da66065e99e3/pone.0282078.g001.jpg

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