2022 年，在埃塞俄比亚奥罗米亚西部地区的 3 家三级医院中，因围产期窒息而住院的新生儿的死亡率及其预测因素。

Incidence and predictors of mortality among neonates admitted with perinatal asphyxia at west Oromia tertiary hospitals, Ethiopia, 2022.

机构信息

Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Pediatr. 2023 Sep 19;23(1):475. doi: 10.1186/s12887-023-04313-6.

BACKGROUND

Perinatal asphyxia is one of the preventable and treatable causes of neonatal mortality. However, it is the fifth-largest cause of under-five mortality. Even with management advancements, it remains one of the key public health issues in underdeveloped countries, including Ethiopia. Comorbidities are also understated; therefore, adequate information regarding the incidence of death and its predictors is required.

METHODS

A four-year retrospective follow-up study was conducted from October 3 to November 2, 2022. From a total sample size, of 655, 616 data were collected by nurse through follow-up reviews charts using Kobo Toolbox software. The data was exported to STATA Version 14 for analysis. The Cox proportional hazard assumption was checked, and the model for the data was selected using Akaike Information Criteria. Finally, an adjusted hazard ratio with 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant predictors of death.

RESULT

The overall incidence of mortality was 38.86/1000 (95% CI: 33.85-44.60). The median time of follow-up was 15 days (95% CI: 14-20). The proportion of deaths was 202 (32.79%, 95% CI: 29.18-36.61) among neonates with perinatal asphyxia. While the distance from health facility > 10 km is (AHR: 2.25; 95% CI: 1.60-3.17), direct oxygen (AHR: 1.83; 95% CI: 1.35-2.48), APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration) < 3 at the fifth minute (AHR: 2.63; 95% CI: 1.03-6.73), prolonged rupture of membrane (AHR: 1.41; 95% CI: 1.02-1.94), and stage III hypoxic ischemic encephalopathy (AHR: 2.02; 95% CI: 1.18-3.47) were predictors of mortality among neonates with perinatal asphyxia.

CONCLUSION

According to this study's findings, high neonatal mortality due to perinatal asphyxia requires proper intervention regarding membrane rupture, APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration), oxygen use, stage III hypoxic-ischemic encephalopathy, and residence distance.

背景

围产期窒息是新生儿死亡可预防和可治疗的原因之一。然而，它是五岁以下儿童死亡的第五大原因。即使管理水平有所提高，它仍然是包括埃塞俄比亚在内的不发达国家的主要公共卫生问题之一。合并症也被低估了；因此，需要充分了解死亡的发生率及其预测因素。

方法

对 2022 年 10 月 3 日至 11 月 2 日进行的一项为期四年的回顾性随访研究进行了评估。在总共的 655 例样本中，通过护士使用 Kobo Toolbox 软件通过随访审查图表收集了 616 例数据。将数据导出到 STATA 版本 14 进行分析。检查了 Cox 比例风险假设，并使用赤池信息量准则为数据选择了模型。最后，计算了调整后的危险比及其 95%CI，多变量分析中 P 值<0.05 的变量被视为死亡的显著预测因素。

结果

总的死亡率为 38.86/1000（95%CI：33.85-44.60）。中位随访时间为 15 天（95%CI：14-20）。围产期窒息新生儿中死亡比例为 202（32.79%，95%CI：29.18-36.61）。而距离卫生机构>10 公里（AHR：2.25；95%CI：1.60-3.17）、直接吸氧（AHR：1.83；95%CI：1.35-2.48）、第 5 分钟 APGAR 评分（外观、脉搏、面部表情、活动和呼吸）<3（AHR：2.63；95%CI：1.03-6.73）、延长的胎膜破裂（AHR：1.41；95%CI：1.02-1.94）和 III 期缺氧缺血性脑病（AHR：2.02；95%CI：1.18-3.47）是围产期窒息新生儿死亡的预测因素。