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埃塞俄比亚南部公立医院基于临床体征、症状及相关因素的新生儿缺氧缺血性脑病:一项病例对照研究

Hypoxic-ischaemic encephalopathy based on clinical signs and symptoms and associated factors among neonates, Southern Ethiopian public hospitals: a case-control study.

作者信息

Melaku Getnet, Mergia Getachew, Getahun Senait Belay, Semagn Selamawit, Awoke Zemedu, Kabthymer Robel Hussien, Abebe Mesfin

机构信息

Departments ofMidwifery.

Obstetrics and Gynecology.

出版信息

Ann Med Surg (Lond). 2023 Dec 2;86(1):35-41. doi: 10.1097/MS9.0000000000001459. eCollection 2024 Jan.

Abstract

BACKGROUND

Hypoxic-ischaemic encephalopathy (HIE) is a severe condition that results from reduced oxygen supply and blood flow to the brain, leading to brain injury and potential long-term neurodevelopmental impairments. This study aimed to identify the maternal and neonatal factors associated with hypoxic-ischaemic encephalopathy among Neonates.

METHODS

The authors conducted a case-control study in 15 public hospitals with 515 neonates and mothers (175 cases and 340 controls). The authors used a questionnaire and clinical records created and managed by Kobo software to collect data. The authors diagnosed hypoxic-ischaemic encephalopathy (HIE) by clinical signs and symptoms. The authors used logistic regression to identify HIE factors.

RESULTS

Hypoxic-ischaemic encephalopathy (HIE) was associated with maternal education, ultrasound checkup, gestational age, delivery mode, and labour duration. Illiterate mothers [adjusted odds ratio (AOR)= 1.913, 95% CI: 1.177, 3.109], no ultrasound checkup (AOR= 1.859, 95% CI: 1.073, 3.221), preterm (AOR= 4.467, 95% CI: 1.993, 10.012) or post-term birth (AOR= 2.903, 95% CI: 1.325, 2.903), caesarean section (AOR= 7.569, 95% CI: 4.169, 13.741), and prolonged labour (AOR= 3.591, 95% CI: 2.067, 6.238) increased the incidence of HIE.

CONCLUSION

This study reveals the factors for hypoxic-ischaemic encephalopathy among neonates in Ethiopia. The authors found that neonates born to illiterate women, those who experienced prolonged labour, those whose mothers did not have ultrasound checkups during pregnancy, those delivered by caesarean section, and those born preterm, or post-term were more likely to develop hypoxic-ischaemic encephalopathy. These findings indicate that enhancing maternal education and healthcare services during pregnancy and delivery may positively reduce hypoxic-ischaemic encephalopathy among neonates.

摘要

背景

缺氧缺血性脑病(HIE)是一种严重疾病,由大脑的氧气供应和血流减少导致,会造成脑损伤以及潜在的长期神经发育障碍。本研究旨在确定新生儿中与缺氧缺血性脑病相关的母体和新生儿因素。

方法

作者在15家公立医院对515名新生儿及其母亲(175例病例和340名对照)进行了一项病例对照研究。作者使用由Kobo软件创建和管理的问卷及临床记录来收集数据。作者通过临床体征和症状诊断缺氧缺血性脑病(HIE)。作者使用逻辑回归来确定HIE的因素。

结果

缺氧缺血性脑病(HIE)与母亲教育程度、超声检查、孕周、分娩方式和产程有关。文盲母亲[调整优势比(AOR)=1.913,95%置信区间:1.177,3.109]、未进行超声检查(AOR=1.859,95%置信区间:1.073,3.221)、早产(AOR=4.467,95%置信区间:1.993,10.012)或过期产(AOR=2.903,95%置信区间:1.325,2.903)、剖宫产(AOR=7.569,95%置信区间:4.169,13.741)以及产程延长(AOR=3.591,95%置信区间:2.067,6.238)会增加HIE的发病率。

结论

本研究揭示了埃塞俄比亚新生儿缺氧缺血性脑病的相关因素。作者发现,文盲妇女所生的新生儿、产程延长的新生儿、母亲孕期未进行超声检查的新生儿、剖宫产出生的新生儿以及早产或过期产的新生儿更易患缺氧缺血性脑病。这些发现表明,在孕期和分娩期间加强母亲教育和医疗服务可能会积极降低新生儿缺氧缺血性脑病的发病率。

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