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埃塞俄比亚西北部贡德尔两个选定卫生机构产后妇女的产后贫血及其决定因素:一项基于机构的横断面研究。

Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study.

作者信息

Bambo Getachew Mesfin, Kebede Samuel Sahile, Sitotaw Chomaw, Shiferaw Elias, Melku Mulugeta

机构信息

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia.

Department of Medical Laboratory Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia.

出版信息

Front Med (Lausanne). 2023 Apr 20;10:1105307. doi: 10.3389/fmed.2023.1105307. eCollection 2023.

Abstract

BACKGROUND

Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally.

OBJECTIVE

The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia.

METHODS

A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A -value <0.05 was considered statistically significant.

RESULTS

The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18).

CONCLUSION

The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

摘要

背景

贫血在全球范围内高度流行,对产后女性的影响尤为严重。它是全球孕产妇死亡和发病的一个重要原因。

目的

本研究的主要目的是确定埃塞俄比亚西北部贡德尔两个选定医疗机构中产后女性的产后贫血程度及相关因素。

方法

2021年3月至5月,对282名产后女性进行了一项基于机构的横断面研究。采用系统抽样技术从每个机构招募研究参与者。通过半结构化问卷收集社会人口学、产科和临床数据。采集静脉血样以确定红细胞参数。制作薄血涂片以检查血液形态。此外,采用直接湿片法和福尔马林 - 乙醚沉淀技术进行粪便检查以识别肠道寄生虫。数据录入EpiData并导出到Stata 14进行统计分析。描述性统计结果以文本、表格和图表形式呈现。采用二元逻辑回归模型确定与产后贫血相关的因素。P值<0.05被认为具有统计学意义。

结果

产后贫血的比例为47.16%;95%置信区间为41.30 - 53.03,其中中度、轻度和重度贫血分别占45.11%、42.86%和12.03%。大多数贫血(94%)为正细胞正色素性贫血。它与产后出血(比值比=2.23;95%置信区间:1.24 - 4.01)、剖宫产(比值比=4.10;95%置信区间:2.11 - 7.78)、孕期缺乏铁和叶酸补充(比值比=2.12;95%置信区间:1.17 - 4.02)以及饮食多样性水平低(比值比=1.83;95%置信区间:1.05 - 3.18)有关。

结论

贫血的患病率被发现是一个主要的公共卫生问题。孕期补充铁和叶酸、改善产后出血的管理、进行有效的剖宫产并做好术后护理以及采取多样化饮食将减轻负担。因此,应考虑已确定的因素以预防和控制产后贫血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0cb/10157165/1e58eb035f8f/fmed-10-1105307-g001.jpg

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