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埃塞俄比亚亚的斯亚贝巴两所选定公立医院中重度子痫前期围产期不良结局的患病率及决定因素

Prevalence and determinants of adverse perinatal outcomes of preeclampsia with severe features at two selected public hospitals in Addis Ababa, Ethiopia.

作者信息

Tadese Mesfin, Damesa Wogene Asefa, Solomon Gebeyehu Shumet, Fitie Girma Wogie, Mitiku Yohannes Moges, Tessema Saba Desta, Endale Agizew

机构信息

Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.

Department of Medicine, Obstetrician and Gynecologist, Abebech Gobena Mothers and Childrens Health Hospital, Addis Ababa, Ethiopia.

出版信息

Front Pediatr. 2024 Feb 8;12:1345055. doi: 10.3389/fped.2024.1345055. eCollection 2024.

Abstract

BACKGROUND

Preeclampsia is a new onset of hypertension and either proteinuria or end-organ failure after 20 weeks of gestation. It is a prevalent cause of perinatal mortality, morbidity, and neonatal complications in developing nations including Ethiopia. Thus, the aimed to assess the prevalence and determinants of adverse perinatal outcomes among women with preeclampsia with severity features (PEWSF) at two selected public hospitals in Addis Ababa, Ethiopia, 2023.

METHOD

A cross-sectional study was carried out among 348 mothers between January 1, 2023, and July 1, 2023. A structured, pre-tested questionnaire was used to gather data from in-person interviews and a review of the patient's medical record. The statistical program Epi-Data version 4.6 was used to enter the data, and SPSS version 26.0 was used for analysis. Binary logistic regression analysis was used to find factors that were associated with unfavorable perinatal outcomes. A -value of less than 0.05 was used to declare the significance level.

RESULT

The overall prevalence of unfavorable perinatal outcomes was 59.2% (95% CI: 54.0-63.8). Among the complications, low birth weight, prematurity, NICU admission, and a low fifth-minute APGAR score, encompass 48.9%, 39.4%, 20.4%, and 14.7%, respectively. No formal education [OR = 5.14, 95% CI: (1.93-13.63)], unemployment [OR = 0.42, 95% CI: (0.24-0.73)], referral cases [OR = 2.03, 95% CI: (1.08-4.06), inadequate antenatal care (ANC) contact [OR = 3.63, 95% CI: (1.22-10.71)], and family history of hypertension [OR = 1.99, 95% CI: (1.03-3.85)] have shown a statistically significant association with unfavorable perinatal outcomes.

CONCLUSION

In this study, the prevalence of unfavorable perinatal outcomes was high compared to other studies in Ethiopia. Level of education, occupation, mode of admission, ANC contact, and family history of hypertension were significant predictors of unfavorable perinatal outcomes. Socio-economic development, improving referral systems, and adequate antenatal care contact are needed to improve unfavorable outcomes. Additionally, antenatal screening and specialized care for high-risk mothers, e.g., those with a family history of hypertension are recommended.

摘要

背景

子痫前期是指妊娠20周后新发高血压并伴有蛋白尿或脏器功能衰竭。在包括埃塞俄比亚在内的发展中国家,它是围产期死亡、发病及新生儿并发症的常见原因。因此,本研究旨在评估2023年埃塞俄比亚亚的斯亚贝巴两家选定公立医院中患有重度子痫前期特征(PEWSF)的女性不良围产期结局的患病率及相关因素。

方法

于2023年1月1日至7月1日对348名母亲进行了一项横断面研究。使用一份经过预测试的结构化问卷,通过面对面访谈和查阅患者病历收集数据。数据录入采用统计软件Epi-Data 4.6版,分析采用SPSS 26.0版。采用二元逻辑回归分析来寻找与不良围产期结局相关的因素。以P值小于0.05作为显著性水平。

结果

不良围产期结局的总体患病率为59.2%(95%CI:54.0 - 63.8)。在并发症中,低出生体重、早产、入住新生儿重症监护病房(NICU)以及出生后五分钟阿氏评分低分别占48.9%、39.4%、20.4%和14.7%。未接受正规教育[OR = 5.14,95%CI:(1.93 - 13.63)]、失业[OR = 0.42,95%CI:(0.24 - 0.73)]、转诊病例[OR = 2.03,95%CI:(1.08 - 4.06)]、产前检查(ANC)接触不足[OR = 3.63,95%CI:(1.22 - 10.71)]以及高血压家族史[OR = 1.99,95%CI:(1.03 - 3.85)]与不良围产期结局在统计学上具有显著关联。

结论

在本研究中,与埃塞俄比亚的其他研究相比,不良围产期结局的患病率较高。教育水平、职业、入院方式、ANC接触以及高血压家族史是不良围产期结局的重要预测因素。需要通过社会经济发展、改善转诊系统以及提供充足的产前检查接触来改善不良结局。此外,建议对高危母亲进行产前筛查和专科护理,例如有高血压家族史的母亲。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1fd/10881656/f9fb7ed84e61/fped-12-1345055-g001.jpg

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