University of Western Australia, Perth, Australia.
Ministry of Health, Thimphu, Bhutan.
Asia Pac J Public Health. 2023 Nov;35(8):486-493. doi: 10.1177/10105395231203112. Epub 2023 Oct 16.
More than half of Bhutan's under-five mortality is attributed to neonatal deaths. Despite this, there is a lack of local evidence on determinants of neonatal mortality. It is critical to generate new evidence to accelerate interventions to achieve sufficient reduction of neonatal mortality rate in line to sustainable development goal target 3.2. Thus, this study was aimed at exploring determinants of neonatal mortality in Bhutan. A case-control study was performed with reported neonatal deaths from hospitals and primary health centers between 2018 and 2019. A total of 181 neonatal deaths were included as cases along with three corresponding controls. Epidata and STATA were used for data management and analysis, respectively. A multivariable model was fitted to identify determinants of neonatal mortality. History of obstetric complications (odds ratio [OR] = 3.53; 95% confidence interval [CI] = 1.48-8.42), intrapartum complications (OR = 3.86; 95% CI = 1.71-8.74) gestational age (OR = 8.07; 95% CI = 2.89-22.52), and Apgar 1 minute (OR = 4.40; 95% CI =1.83-10.59) were associated with neonatal death. Therefore, quality of care during pregnancy and childbirth besides promoting supportive family environment is essential to reduce neonatal mortality.
不丹超过一半的五岁以下儿童死亡归因于新生儿死亡。尽管如此，当地仍缺乏关于新生儿死亡决定因素的证据。为了加速干预措施的实施，以实现与可持续发展目标 3.2 相一致的新生儿死亡率的充分降低，产生新的证据至关重要。因此，本研究旨在探讨不丹新生儿死亡的决定因素。采用病例对照研究，对 2018 年至 2019 年期间医院和初级卫生中心报告的新生儿死亡进行了研究。共有 181 例新生儿死亡被纳入病例，同时纳入了 3 名相应的对照。使用 Epidata 和 STATA 分别进行数据管理和分析。建立多变量模型来确定新生儿死亡的决定因素。产科并发症史（比值比 [OR] = 3.53；95%置信区间 [CI] = 1.48-8.42）、分娩期并发症（OR = 3.86；95% CI = 1.71-8.74）、胎龄（OR = 8.07；95% CI = 2.89-22.52）和 1 分钟 Apgar 评分（OR = 4.40；95% CI = 1.83-10.59）与新生儿死亡相关。因此，除了促进支持性家庭环境外，孕期和分娩期的护理质量对于降低新生儿死亡率至关重要。
