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赞比亚一家三级医院新生儿低出生体重的决定因素和结局:一项回顾性队列研究。

Determinants and outcomes of low birth weight among newborns at a tertiary hospital in Zambia: A retrospective cohort study.

机构信息

Department of Pharmacy, School of Health Sciences, University of Zambia; Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia; Lusaka Zambia, HIV and Women's Health Research Group, University Teaching Hospital, Lusaka, Zambia.

Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.

出版信息

Ann Afr Med. 2023 Jul-Sep;22(3):271-278. doi: 10.4103/aam.aam_22_22.

Abstract

CONTEXT

Newborns' low birth weight (LBW) has been linked to early infant morbidity and mortality. However, our understanding of the determinants and outcomes of LBW in this population is still poor.

AIM

This study aimed to assess determinants and outcomes of LBW among newborns at a tertiary hospital.

SETTINGS AND DESIGN

Retrospective cohort study at Women and Newborn Hospital in Lusaka Zambia.

SUBJECTS AND METHODS

We reviewed delivery case records and neonatal files between January 1, 2018, and September 30, 2019, for newborns admitted to the neonatal intensive care unit.

STATISTICAL ANALYSIS USED

Logistic regression models were used to establish determinants of LBW and describe the outcomes.

RESULTS

Women living with human immunodeficiency virus infection were more likely to deliver LBW infants (adjusted odds ratio [AOR] = 1.46; 95% confidence interval [CI]: 1.16-1.86). Other maternal determinants of LBW were; increased parity (AOR = 1.22; 95% CI: 1.05-1.43), preeclampsia (AOR = 6.91; 95% CI: 1.48-32.36), and gestational age <37 weeks compared to 37 weeks or more (AOR = 24.83; 95% CI: 13.27-46.44). LBW neonates were at higher odds of early mortality (AOR = 2.16; 95% CI: 1.85-2.52), developing respiratory distress syndrome (AOR = 2.96; 95% CI: 2.53-3.47), and necrotizing enterocolitis (AOR = 1.66; 95% CI: 1.16-2.38) than neonates with a birth weight of 2500 g or more.

CONCLUSIONS

These findings underscore the importance of effective maternal and neonatal interventions to reduce the risk of morbidity and mortality for neonates with LBW in Zambia and other similar settings.

摘要

背景

新生儿低出生体重(LBW)与婴儿早期发病率和死亡率有关。然而,我们对该人群 LBW 的决定因素和结局的了解仍然有限。

目的

本研究旨在评估赞比亚卢萨卡一家三级医院新生儿 LBW 的决定因素和结局。

设置和设计

在赞比亚卢萨卡的妇女和新生儿医院进行的回顾性队列研究。

研究对象和方法

我们回顾了 2018 年 1 月 1 日至 2019 年 9 月 30 日期间入住新生儿重症监护病房的新生儿的分娩病历和新生儿档案。

统计分析

使用逻辑回归模型确定 LBW 的决定因素并描述结局。

结果

感染人类免疫缺陷病毒的妇女更有可能分娩 LBW 婴儿(调整后的优势比 [AOR] = 1.46;95%置信区间 [CI]:1.16-1.86)。LBW 的其他产妇决定因素包括:产次增加(AOR = 1.22;95% CI:1.05-1.43)、子痫前期(AOR = 6.91;95% CI:1.48-32.36)和妊娠 37 周以下与 37 周或以上(AOR = 24.83;95% CI:13.27-46.44)。LBW 新生儿的早期死亡率(AOR = 2.16;95% CI:1.85-2.52)、呼吸窘迫综合征(AOR = 2.96;95% CI:2.53-3.47)和坏死性小肠结肠炎(AOR = 1.66;95% CI:1.16-2.38)的风险更高,而体重 2500 克或以上的新生儿。

结论

这些发现强调了在赞比亚和其他类似环境中,需要采取有效的母婴干预措施,以降低 LBW 新生儿发病率和死亡率的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5bd/10445713/2be58d9f9942/AAM-22-271-g001.jpg

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