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加纳新生儿死亡的预测因素:来自 2017 年加纳产妇健康调查的证据。

Predictors of neonatal mortality in Ghana: evidence from 2017 Ghana maternal health survey.

机构信息

World Child Cancer, Moorfields House, Slater Avenue, Korle Bu, P. O. Box KB273, Accra, Ghana.

Ghana College of Nurses and Midwives, 214 Westlands Residential Area, Accra, Ghana.

出版信息

BMC Pregnancy Childbirth. 2023 Aug 2;23(1):556. doi: 10.1186/s12884-023-05877-y.

Abstract

BACKGROUND

Neonatal mortality contributes about 47% of child mortality globally and over 50% of under-5 deaths in Ghana. There is limited population level analysis done in Ghana on predictors of neonatal mortality.

OBJECTIVES

The objective of the study was to examine the predictors of neonatal mortality in Ghana.

METHOD

This study utilizes secondary data from the 2017 Ghana Maternal Health Survey (GMHS). The GMHS survey focuses on population and household characteristics, health, nutrition, and lifestyle with particular emphasis on topics that affect the lives of newborns and women, including mortality levels, fertility preferences and family planning methods. A total of 10,624 respondents were included in the study after data cleaning. Descriptive statistical techniques were used to describe important background characteristics of the women and Pearson's Chi-squares (χ) test used to assess association between the outcome (neonatal death) and independent variables. Multivariate logistic regression analysis was done to estimate odd ratios and potential confounders controlled. Confidence level was held at 95%, and a p < 0.05 was considered statistically significant. Data analysis was done using STATA 15.

RESULTS

The prevalence of neonatal mortality was 18 per 1000 live births. ANC attendance, sex of baby, and skin-to-skin contact immediately after birth were predictors of neonatal mortality. Women with at least one ANC visit were less likely to experience neonatal mortality as compared to women with no ANC visit prior to delivery (AOR = 0.11; CI = 0.02-0.56, p = 0.01). Girls were less likely (AOR = 0.68; CI = 0.47-0.98; p = 0.03) to die during the neonatal period as compared to boys. Neonates who were not put skin-to-skin contact immediately after birth were 2.6 times more likely to die within the neonatal period than those who were put skin-to-skin contact immediately after birth (AOR = 2.59; CI = 1.75-3.83, p = 0.00).

CONCLUSION

Neonatal mortality remains a public health concern in Ghana, with an estimated rate of 18 deaths per 1,000 live births. Maternal and neonatal factors such as the sex of the newborn, the number of antenatal care visits, and skin-to-skin contact between the newborn and mother immediately after birth are the predictors of neonatal mortality in Ghana.

摘要

背景

新生儿死亡约占全球儿童死亡的 47%,占加纳五岁以下儿童死亡人数的 50%以上。加纳在人口层面上对新生儿死亡的预测因素进行的分析有限。

目的

本研究旨在探讨加纳新生儿死亡的预测因素。

方法

本研究利用 2017 年加纳产妇健康调查(GMHS)的二次数据。GMHS 调查侧重于人口和家庭特征、健康、营养和生活方式,特别关注影响新生儿和妇女生活的主题,包括死亡率水平、生育偏好和计划生育方法。在数据清理后,共有 10624 名受访者纳入研究。采用描述性统计技术描述了妇女的重要背景特征,并采用 Pearson 卡方检验(χ 检验)评估了结局(新生儿死亡)与自变量之间的关联。采用多变量逻辑回归分析估计优势比,并控制潜在混杂因素。置信水平为 95%,p<0.05 被认为具有统计学意义。数据分析使用 STATA 15 进行。

结果

新生儿死亡率为 18 例/1000 例活产。产前检查、婴儿性别和出生后立即进行皮肤接触是新生儿死亡的预测因素。与分娩前未接受任何产前检查的妇女相比,至少接受一次产前检查的妇女发生新生儿死亡的可能性较小(AOR=0.11;CI=0.02-0.56,p=0.01)。与男孩相比,女孩在新生儿期死亡的可能性较低(AOR=0.68;CI=0.47-0.98;p=0.03)。出生后未立即进行皮肤接触的新生儿在新生儿期死亡的可能性是立即进行皮肤接触的新生儿的 2.6 倍(AOR=2.59;CI=1.75-3.83,p=0.00)。

结论

新生儿死亡仍然是加纳的一个公共卫生问题,估计每 1000 例活产中有 18 例死亡。产妇和新生儿因素,如新生儿性别、产前护理次数以及新生儿出生后立即与母亲进行皮肤接触,是加纳新生儿死亡的预测因素。

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