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在埃塞俄比亚东部的选定三级医院中,子痫前期和重度子痫前期妇女的围产期结局及其决定因素。

Perinatal outcomes and their determinants among women with eclampsia and severe preeclampsia in selected tertiary hospitals, Eastern Ethiopia.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Department of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

Pregnancy Hypertens. 2023 Dec;34:152-158. doi: 10.1016/j.preghy.2023.11.005. Epub 2023 Nov 21.

DOI:10.1016/j.preghy.2023.11.005
PMID:37992489
Abstract

BACKGROUND

Neonatal complications and deaths are still increasing worldwide. Therefore, this study aimed to assess perinatal outcomes and their determinants among women with eclampsia and severe preeclampsia admitted to selected tertiary hospitals Eastern Ethiopia.

METHODS

The prospective observational study was conducted among 245 foetal born to women with eclampsia and severe preeclampsia admitted to selected Hospitals. Data were collected from patients' charts and maternal interviews using questionnaires and telephone follow-ups from April 01 to September 30, 2022. Then, Cox regression were used to determine the predictors of perinatal clinical outcomes by SPSS (version 21.0®). Hazard ratios with a two-sided P-value < 0.05 were considered statistically significant.

RESULT

Of 245 deliveries, perinatal mortality was 26.1 % and about 57.4 % of newborns developed neonatal complications. Fifth-minute Apgar score (AHR: 10.3; 95 % C.I: 3.8-28.1; P: 0.0001) was statistically a determinant to perinatal mortality whereas maternal parity (AHR: 1.7; 95 % CI: 1.0-2.86; P: 0.05), maternal diagnosis (AHR: 2.1; 95 % C.I:1.17-3.66; P: 0.012), maternal complications (AHR: 1.96; 95 % C.I: 1.13-3.41; P: 0.018) and fifth-minute Apgar score (AHR: 2.0; 95 % C.I: 1.29-3.19; P: 0.002) were found to be determinants for neonatal complications.

CONCLUSION

Despite the inclusion of magnesium sulphate into the national drug list of Ethiopia to reduce maternal and perinatal morbidity and mortality, the perinatal condition remained a severe concern and worse among patients with eclampsia. Interventions to reduce the incidence of eclampsia, better antenatal care, early recognition, prompt treatment of severe preeclampsia, and enhanced neonatal care have to be initiated for patients.

摘要

背景

新生儿并发症和死亡人数仍在全球范围内上升。因此,本研究旨在评估在选定的埃塞俄比亚东部三级医院住院的子痫和重度子痫前期妇女的围产期结局及其决定因素。

方法

这项前瞻性观察性研究是在 2022 年 4 月 1 日至 9 月 30 日期间,对 245 名因子痫和重度子痫前期而分娩的胎儿在选定的医院进行的。数据是从患者的病历和产妇访谈中收集的,使用问卷和电话随访。然后,使用 SPSS(版本 21.0®)中的 Cox 回归来确定围产期临床结局的预测因素。双侧 P 值<0.05 的风险比被认为具有统计学意义。

结果

在 245 例分娩中,围产儿死亡率为 26.1%,约 57.4%的新生儿出现新生儿并发症。第五分钟 Apgar 评分(AHR:10.3;95%置信区间:3.8-28.1;P:0.0001)是围产儿死亡的统计学决定因素,而产妇产次(AHR:1.7;95%置信区间:1.0-2.86;P:0.05)、产妇诊断(AHR:2.1;95%置信区间:1.17-3.66;P:0.012)、产妇并发症(AHR:1.96;95%置信区间:1.13-3.41;P:0.018)和第五分钟 Apgar 评分(AHR:2.0;95%置信区间:1.29-3.19;P:0.002)是新生儿并发症的决定因素。

结论

尽管在埃塞俄比亚国家药物清单中纳入硫酸镁以降低孕产妇和围产儿发病率和死亡率,但围产期状况仍然是一个严重的问题,子痫患者的情况更糟。必须为患者启动减少子痫发生率、加强产前保健、及早识别、及时治疗重度子痫前期和加强新生儿护理的干预措施。

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