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哈萨克斯坦共和国脑性瘫痪的流行病学:发病率及风险因素

Epidemiology of cerebral palsy in the Republic of Kazakhstan: Incidence and risk factors.

作者信息

Zhakupova Maiya, Nurbakyt Ardak, Ospanova Dinara, Chuyenbekova Ardak, Kozhekenova Zhanat, Dauletova Gauhar, Aitmanbetova Akmaral, Abdikadir Maksat, Padaiga Zhilvinas, Izmailovich Marina, Glushkova Natalya, Semenova Yuliya

机构信息

Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan.

出版信息

Heliyon. 2023 Mar 24;9(4):e14849. doi: 10.1016/j.heliyon.2023.e14849. eCollection 2023 Apr.

Abstract

BACKGROUND

There is a paucity of robust data on the incidence and causes of cerebral palsy (CP) in Central Asian countries, while this information is important for planning local healthcare services. This epidemiological study was designed to clear the gap in knowledge on both the incidence of CP and the underlying risk factors in the Republic of Kazakhstan.

METHODS

This was a retrospective study that comprised two stages. At the first stage, a cross-sectional analysis of CP frequencies was performed on the basis of official statistics obtained from the Republican Center for Health Development. A study with age- and sex-matched controls was carried out at the second stage to elucidate the maternal and neonatal risk factors associated with CP.

RESULTS

Mild variability in national CP incidence was observed, ranging from 68.7 to 83.3 per 100,000 population. A number of maternal risk factors were significantly associated with CP, including arterial hypertension, thrombocytopenia, diabetes mellitus, pathology of fetal membranes, premature rupture of membranes, and acute respiratory illness during pregnancy. Low Apgar score, gestational age, birth weight, and presence of intraventricular hemorrhage or periventricular leukomalacia were among the important neonatal risk factors.

CONCLUSION

There is a need for a more comprehensive prospective study to document the extent of the CP problem in Kazakhstan. In addition, a national CP registry must be envisaged to overcome the lack of essential data.

摘要

背景

中亚国家关于脑瘫(CP)发病率及病因的可靠数据匮乏,而这些信息对于规划当地医疗服务至关重要。这项流行病学研究旨在填补哈萨克斯坦共和国在脑瘫发病率及潜在风险因素方面的知识空白。

方法

这是一项回顾性研究,包括两个阶段。第一阶段,基于从共和国卫生发展中心获得的官方统计数据,对脑瘫发病率进行横断面分析。第二阶段开展了一项年龄和性别匹配对照的研究,以阐明与脑瘫相关的孕产妇和新生儿风险因素。

结果

观察到全国脑瘫发病率存在轻微差异,每10万人口中发病率在68.7至83.3之间。一些孕产妇风险因素与脑瘫显著相关,包括动脉高血压、血小板减少症、糖尿病、胎膜病变、胎膜早破以及孕期急性呼吸道疾病。低阿氏评分、孕周、出生体重以及脑室内出血或脑室周围白质软化的存在是重要的新生儿风险因素。

结论

需要开展更全面的前瞻性研究,以记录哈萨克斯坦脑瘫问题的严重程度。此外,必须设想建立一个全国性的脑瘫登记处,以克服关键数据缺失的问题。

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