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与埃塞俄比亚东北部转诊医院新生儿高胆红素血症相关的因素:基于机构的非匹配病例对照研究。

Factors associated with neonatal jaundice among neonates admitted at referral hospitals in northeast Ethiopia: a facility-based unmatched case-control study.

机构信息

School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2024 Feb 21;24(1):150. doi: 10.1186/s12884-024-06352-y.

Abstract

BACKGROUND

Neonatal jaundice is a significant contributor to illness and death in newborns, leading to frequent admissions to neonatal intensive care units. To better understand this issue, a study was conducted to identify the factors contributing to neonatal jaundice among newborns admitted to Dessie and Woldia comprehensive specialized hospitals in northeast Ethiopia.

METHODS

The study took place from April 1 to May 30, 2022, using unmatched case-control design. A total of 320 neonates paired with their mothers were involved, including 64 cases and 256 controls. Data were collected through a structured interviewer-administered questionnaire and a review of medical records. The collected data were analyzed using SPSS Version 23, and a multivariate logistic regression model was employed to understand the relationship between independent factors and the occurrence of neonatal jaundice. Statistical significance was determined at a threshold of P value less than 0.05.

RESULTS

The study findings revealed that maternal age over 35 years, residing in urban areas [adjusted odds ratio (AOR) = 2.4, 95% confidence interval (CI): 1.23, 4.82], male gender (AOR = 4.3, 95% CI: 1.90, 9.74), prematurity (AOR = 3.9, 95% CI: 1.88, 8.09), and ABO incompatibility (AOR = 2.6, 95% CI: 1.16, 5.96) were significant determinants of neonatal jaundice. Conversely, the study indicated that cesarean birth was associated with a 76% lower likelihood of infant jaundice compared to vaginal delivery (AOR = 0.24, 95% CI: 0.08, 0.72).

CONCLUSION

To prevent, diagnose, and treat neonatal jaundice effectively, efforts should primarily focus on managing ABO incompatibility and early detection of prematurity. Additionally, special attention should be given to neonates born through vaginal delivery, those with mothers over 35 years old, and those residing in urban areas, as they are at higher risk of developing newborn jaundice. Close monitoring of high-risk mother-infant pairs during the antenatal and postnatal periods, along with early intervention, is crucial for reducing the severity of neonatal jaundice in this study setting.

摘要

背景

新生儿黄疸是导致新生儿患病和死亡的一个重要因素,这导致他们经常需要入住新生儿重症监护病房。为了更好地了解这一问题,我们在埃塞俄比亚东北部的德西和沃尔迪亚综合专科医院进行了一项研究,旨在确定导致新生儿黄疸的因素。

方法

本研究于 2022 年 4 月 1 日至 5 月 30 日采用非匹配病例对照设计进行,共纳入 320 对母亲和新生儿,其中 64 例为病例,256 例为对照。通过结构式访谈员管理的问卷和病历回顾收集数据。采用 SPSS 版本 23 进行数据分析,采用多变量逻辑回归模型了解独立因素与新生儿黄疸发生之间的关系。以 P 值小于 0.05 为统计学显著性阈值。

结果

研究结果表明,母亲年龄大于 35 岁、居住在城市地区[校正比值比(AOR)=2.4,95%置信区间(CI):1.23,4.82]、男性(AOR=4.3,95%CI:1.90,9.74)、早产(AOR=3.9,95%CI:1.88,8.09)和 ABO 不相容(AOR=2.6,95%CI:1.16,5.96)是新生儿黄疸的显著决定因素。相反,研究表明与阴道分娩相比,剖宫产分娩婴儿患黄疸的可能性降低 76%(AOR=0.24,95%CI:0.08,0.72)。

结论

为了有效预防、诊断和治疗新生儿黄疸,应主要侧重于管理 ABO 不相容和早期发现早产。此外,应特别关注阴道分娩出生的新生儿、母亲年龄大于 35 岁的新生儿以及居住在城市地区的新生儿,因为他们发生新生儿黄疸的风险更高。在围产期密切监测高危母婴对,并进行早期干预,对于降低本研究环境中新生儿黄疸的严重程度至关重要。

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