Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2024 Apr 1;19(4):e0298319. doi: 10.1371/journal.pone.0298319. eCollection 2024.
Adverse birth outcomes are the leading cause of neonatal mortality worldwide. Ethiopia is one of the countries struggling to reduce neonatal mortality through different strategies, but neonatal mortality remains high for many reasons. Despite adverse birth outcomes being a public health problem in Ethiopia, the contribution of Premature rupture of the membrane to the adverse fetal birth outcome is neglected and not well explained in our country. This study aims to assess fetal birth outcomes and associated factors among mothers with all types of PROM at Specialized Hospitals in Amhara Region, Ethiopia.
A facility-based cross-sectional study design was applied among 538 mothers with premature rapture of the membrane at Amhara region specialized hospitals. A simple random sampling technique was employed to select the medical charts diagnosed with all types of PROM and giving birth in the hospital within the period from July 8, 2019, to July 7, 2021. The data was collected using a checklist, entered into EPI Data version 3.1, and analyzed using SPSS version 23. A binary logistic regression model was used to see the association between independent and dependent variables. A P-value <0.05 was used to declare the statistical significance. The AOR with 95% CI was used to measure the strength of the association.
Adverse birth outcome among all types of Premature rupture of membrane mothers was 33.1% [95% CI 29.2-37.2]. Rural residents [AOR = 2.94, 95% CI:1.73-4.97], have a history of urinary tract infection [AOR = 6.87, 95% CI: 2.77-17.01], anemia [AOR = 7.51, 95% CI: 2.88-19.62], previous history of adverse birth outcome [AOR = 3.54, 95% CI: 1.32-9.47] and less than two years interpregnancy interval [AOR = 6.07, 95% CI: 2.49-14.77] were positively associated with adverse birth outcome compared to their counterparts.
The adverse birth outcome was high in the Amhara region as compared to the World Health Organization's estimated figure and target; the target is less than 15%. History of the previous adverse birth outcome, residence, urinary tract infection, Anemia, and interpregnancy interval had an association with adverse birth outcomes. Therefore, strengthening close follow-up for mothers who had previous adverse birth outcomes, screening and treatment of urinary tract infection, anemia prevention, and maximizing birth interval are recommended for reducing adverse birth outcomes.
不良出生结局是全球新生儿死亡的主要原因。埃塞俄比亚是通过不同策略努力降低新生儿死亡率的国家之一,但由于多种原因,新生儿死亡率仍然很高。尽管不良出生结局是埃塞俄比亚的一个公共卫生问题,但胎膜早破对不良胎儿出生结局的贡献在我国被忽视,没有得到很好的解释。本研究旨在评估在阿姆哈拉地区专科医院中所有类型胎膜早破的母亲的胎儿出生结局及其相关因素。
采用在阿姆哈拉地区专科医院中对所有类型胎膜早破的 538 名母亲进行基于设施的横断面研究设计。采用简单随机抽样技术,选择在 2019 年 7 月 8 日至 2021 年 7 月 7 日期间在医院内诊断为所有类型胎膜早破并在医院分娩的病历。使用检查表收集数据,将数据输入 EPI Data 版本 3.1,并使用 SPSS 版本 23 进行分析。使用二元逻辑回归模型来观察独立和因变量之间的关联。P 值<0.05 用于表示统计学意义。使用 AOR 和 95%CI 来衡量关联的强度。
所有类型胎膜早破母亲的不良出生结局为 33.1%[95%CI 29.2-37.2]。农村居民[AOR=2.94,95%CI:1.73-4.97]、有尿路感染史[AOR=6.87,95%CI:2.77-17.01]、贫血[AOR=7.51,95%CI:2.88-19.62]、有不良出生结局史[AOR=3.54,95%CI:1.32-9.47]和两次妊娠间隔小于两年[AOR=6.07,95%CI:2.49-14.77]与不良出生结局呈正相关。
与世界卫生组织估计的数字和目标相比,阿姆哈拉地区的不良出生结局较高;目标是低于 15%。既往不良出生结局史、居住地、尿路感染、贫血和妊娠间隔与不良出生结局有关。因此,建议加强对有既往不良出生结局史的母亲进行密切随访,筛查和治疗尿路感染,预防贫血,并最大限度地延长生育间隔,以降低不良出生结局的发生。