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在埃塞俄比亚中西部 Shewa 区公立医院新生儿重症监护病房,因出生窒息而入院的新生儿死亡率的发生率和预测因素。

Incidence and predictors of mortality among neonates admitted with birth asphyxia to neonatal intensive care unit of West Shewa Zone Public Hospitals, Central Ethiopia.

机构信息

Department of Midwifery, Ambo University, Ambo, Ethiopia

Department of Midwifery, Ambo University, Ambo, Ethiopia.

出版信息

BMJ Paediatr Open. 2024 Apr 5;8(1):e002403. doi: 10.1136/bmjpo-2023-002403.

Abstract

BACKGROUND

Birth asphyxia is still one of the primary causes of newborn mortality worldwide. Similarly, the risk of newborn asphyxia in Ethiopia remains unacceptably high. Thus, studies on the incidence and predictors of mortality among newborns admitted with birth asphyxia are crucial to addressing this problem. As a result, the purpose of this study was to assess the incidence and predictors of mortality among neonates admitted with birth asphyxia to the neonatal intensive care units (NICUs) of West Shewa Zone Public Hospitals in Central Ethiopia.

METHODS

An institution-based retrospective cohort study was conducted among 760 asphyxiated neonates admitted to the NICUs of West Shewa Zone Public Hospitals between 30 March 2021 and 30 April 2023. The data were collected using CSEntry and analysed bu using Stata V.17. Bivariate and multivariate Cox proportional hazard regression analyses were carried out, and significant predictors were found using a 95% CI and a p<0.05.

RESULTS

A total of 760 asphyxiated neonates were followed for a total of 6880 neonatal days. At the end of follow-up, 263 (34.6%) of the neonates died (95% CI 31.3% to 38.1%), which resulted in a mortality incidence of 10.6/100 person-days of observation. Chewing khat (adjusted HR, AHR 2.21; 95% CI 1.13 to 4.31), home delivery (AHR 1.45, 95% CI 1.1 to 1.9), lack of antenatal care follow-up (AHR 1.44, 95% CI 1.08 to 1.89), hypothermia (AHR 1.56, 95% CI 1.12 to 2.17), hypoglycaemia (AHR 2.23, 95% CI 1.91 to 2.25) and obstructed labour (AHR 1.4, 95% CI 1.02 to 1.91) were found to be the significant predictors of neonatal mortality among asphyxiated neonates at a p≤0.05.

CONCLUSION AND RECOMMENDATION

The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Therefore, in order to significantly reduce the risks of birth asphyxia and subsequent newborn death, all interested stakeholders should take these predictors into consideration.

摘要

背景

出生窒息仍然是全球新生儿死亡的主要原因之一。同样,埃塞俄比亚新生儿窒息的风险仍然高得令人无法接受。因此,研究新生儿窒息入院患者的死亡率及其预测因素对于解决这一问题至关重要。因此,本研究旨在评估在埃塞俄比亚中中央西谢瓦地区公立医院新生儿重症监护病房(NICU)入院的窒息新生儿的死亡率及其预测因素。

方法

这是一项在 2021 年 3 月 30 日至 2023 年 4 月 30 日期间入住西谢瓦地区公立医院 NICU 的 760 名窒息新生儿中进行的基于机构的回顾性队列研究。使用 CSEntry 收集数据,并使用 Stata V.17 进行分析。进行了单变量和多变量 Cox 比例风险回归分析,并使用 95%CI 和 p<0.05 确定了显著的预测因素。

结果

共对 760 名窒息新生儿进行了为期 6880 个新生儿日的随访。在随访结束时,263 名(34.6%)新生儿死亡(95%CI 31.3%至 38.1%),导致死亡率为 10.6/100 人天观察。咀嚼恰特草(调整后的 HR,AHR 2.21;95%CI 1.13 至 4.31)、家庭分娩(AHR 1.45,95%CI 1.1 至 1.9)、缺乏产前护理随访(AHR 1.44,95%CI 1.08 至 1.89)、低体温(AHR 1.56,95%CI 1.12 至 2.17)、低血糖(AHR 2.23,95%CI 1.91 至 2.25)和分娩受阻(AHR 1.4,95%CI 1.02 至 1.91)被发现是窒息新生儿死亡的显著预测因素(p≤0.05)。

结论和建议

研究地区窒息新生儿的死亡率很高。因此,为了显著降低出生窒息和随后新生儿死亡的风险,所有利益相关者都应考虑这些预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d6/11002380/f0614b12009d/bmjpo-2023-002403f01.jpg

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