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一项关于孕产妇险些发生死亡事件及其不良围产期结局的队列研究:埃塞俄比亚西北部的一项产科研究结果

A cohort study of maternal near-miss events and its adverse perinatal outcomes: an obstetrical finding in Northwest Ethiopia.

作者信息

Erega Besfat Berihun, Ferede Wassie Yazie

机构信息

Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debra Tabor, Ethiopia.

出版信息

AJOG Glob Rep. 2024 Jan 20;4(1):100311. doi: 10.1016/j.xagr.2024.100311. eCollection 2024 Feb.

Abstract

BACKGROUND

Globally, various studies have reported that most adverse perinatal outcomes were associated with maternal near-misses. In Ethiopia, studies on adverse perinatal outcomes from maternal near-miss are scarce.

OBJECTIVE

This study aimed to assess the incidence, determinants, and maternal near-miss effects on perinatal outcomes among women at public hospitals in the South Gondar zone in 2021.

STUDY DESIGN

A facility-based prospective cohort study was conducted from January 10, 2021, to May 10, 2021. The chi-square test, multivariable logistic regression methods, and SPSS software were used. The strength of associations and significance level were examined using values and odds ratios with 95% confidence intervals, respectively. In addition, multicollinearity and model fitness were checked.

RESULTS

A total of 304 respondents (76 exposed and 228 unexposed) were included in the study with a response rate of 100.0%. The incidence rates of adverse perinatal outcomes among exposed and unexposed groups were 71.1% (95% confidence interval, 60.0-73.8) and 21.1% (95% confidence interval, 15.8-28.8), respectively. Multivariable logistic regression showed that short interbirth interval (adjusted odds ratio, 8.39; 95% confidence interval, 5.36-16.08), lower household income (adjusted odds ratio, 3.61; 95% confidence interval, 1.12-6.54), rural residence (adjusted odds ratio, 2.54; 95% confidence interval, 1.21-4.07), previous stillbirth (adjusted odds ratio, 4.24; 95% confidence interval, 1.04-17.31), absence of antenatal care (adjusted odds ratio, 9.84; 95% confidence interval, 4.89-17.51), and anemia (adjusted odds ratio, 4.19; 95% confidence interval, 1.01-17.46) were significantly associated with increased odds of adverse perinatal outcomes.

CONCLUSION

This study revealed that the incidence of adverse perinatal outcomes was significantly higher among exposed groups than unexposed groups. The result signified the need for improving the health of mothers by all stakeholders to improve perinatal outcomes.

摘要

背景

在全球范围内,多项研究报告称,大多数围产期不良结局与孕产妇接近死亡情况相关。在埃塞俄比亚,关于孕产妇接近死亡导致围产期不良结局的研究很少。

目的

本研究旨在评估2021年南贡德尔地区公立医院中孕产妇接近死亡情况对围产期结局的发生率、决定因素及影响。

研究设计

于2021年1月10日至2021年5月10日进行了一项基于机构的前瞻性队列研究。使用了卡方检验、多变量逻辑回归方法和SPSS软件。分别使用P值和95%置信区间的比值比来检验关联强度和显著性水平。此外,还检查了多重共线性和模型拟合度。

结果

共有304名受访者(76名暴露组和228名非暴露组)纳入研究,应答率为100.0%。暴露组和非暴露组围产期不良结局的发生率分别为71.1%(95%置信区间,60.0 - 73.8)和21.1%(95%置信区间,15.8 - 28.8)。多变量逻辑回归显示,生育间隔短(调整后的比值比,8.39;95%置信区间,5.36 - 16.08)、家庭收入较低(调整后的比值比,3.61;95%置信区间,1.12 - 6.54)、农村居住(调整后的比值比,2.54;95%置信区间,1.21 - 4.07)、既往死产史(调整后的比值比,4.24;95%置信区间,1.04 - 17.31)、未进行产前检查(调整后的比值比,9.84;95%置信区间,4.89 - 17.51)和贫血(调整后的比值比,4.19;95%置信区间,1.01 - 17.46)与围产期不良结局发生几率增加显著相关。

结论

本研究表明,暴露组围产期不良结局的发生率显著高于非暴露组。该结果表明所有利益相关者都需要改善母亲的健康状况以改善围产期结局。

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本文引用的文献

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Indicators for maternal near miss: an observational study, India.
Bull World Health Organ. 2022 Jul 1;100(7):436-446. doi: 10.2471/BLT.21.287737. Epub 2022 Jun 2.
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Applicability of the WHO maternal near miss tool in sub-Saharan Africa: a systematic review.
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Severe maternal outcomes in eastern Ethiopia: Application of the adapted maternal near miss tool.
PLoS One. 2018 Nov 14;13(11):e0207350. doi: 10.1371/journal.pone.0207350. eCollection 2018.

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