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撒哈拉以南非洲地区的早期新生儿死亡率及其决定因素:来自最近的人口与健康调查数据的发现。

Early neonatal mortality and determinants in sub-Saharan Africa: Findings from recent demographic and health survey data.

机构信息

Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Health system and Policy, College of Medicine and Health Science, School of Public Health, Wollo University, Dessie, Ethiopia.

出版信息

PLoS One. 2024 Jun 7;19(6):e0304065. doi: 10.1371/journal.pone.0304065. eCollection 2024.

Abstract

INTRODUCTION

Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are, however, very few reports about the issue in sub-Saharan Africa. For the sake of developing appropriate policies and initiatives that could aid in addressing the issue, it is important to study the prevalence of mortality during the early neonatal period and associated factors. Thus, the aim of this study was to ascertain the prevalence of and pinpoint the contributing factors to early neonatal mortality in sub-Saharan Africa.

METHOD

Data from recent demographic and health surveys in sub-Saharan African countries was used for this study. The study included 262,763 live births in total. The determinants of early newborn mortality were identified using a multilevel mixed-effects logistic regression model. To determine the strength and significance of the association between outcome and explanatory variables, the adjusted odds ratio (AOR) at a 95% confidence interval (CI) was computed. Independent variables were deemed statistically significant when the p-value was less than the significance level (0.05).

RESULT

Early neonatal mortality in sub-Saharan Africa was 22.94 deaths per 1,000 live births. It was found to be significantly associated with maternal age over 35 years (AOR = 1.77, 95% CI: 1.34-2.33), low birth weight (AOR = 3.27, 95% CI: 2.16, 4.94), less than four ANC visits (AOR = 1.12, 95% CI: 1.01, 1.33), delivery with caesarean section (AOR = 1.81, 95% CI: 1.30-2.5), not having any complications during pregnancy (AOR = 0.76, 95% CI: 0.61, 94), and community poverty (AOR = 1.32, 95% CI: 1.05-1.65).

CONCLUSION

This study found that about twenty-three neonates out of one thousand live births died within the first week of life in sub-Saharan Africa. The age of mothers, birth weight, antenatal care service utilization, mode of delivery, multiple pregnancy, complications during pregnancy, and community poverty should be considered while designing policies and strategies targeting early neonatal mortality in sub-Saharan Africa.

摘要

简介

新生儿在生命的第一周死亡是一个全球性问题,它导致了五岁以下儿童死亡的很大一部分。然而,撒哈拉以南非洲地区对此问题的报道却很少。为了制定有助于解决该问题的适当政策和倡议,研究早期新生儿死亡率及其相关因素是很重要的。因此,本研究旨在确定撒哈拉以南非洲地区早期新生儿死亡率的流行情况和相关因素。

方法

本研究使用了撒哈拉以南非洲国家最近的人口和健康调查数据。该研究总共包括 262763 例活产儿。使用多水平混合效应逻辑回归模型确定了早期新生儿死亡的决定因素。使用调整后的优势比(AOR)和 95%置信区间(CI)来确定结局与解释变量之间的关联强度和显著性。当 p 值小于显著性水平(0.05)时,认为独立变量具有统计学意义。

结果

撒哈拉以南非洲地区的早期新生儿死亡率为每 1000 例活产儿 22.94 例死亡。研究发现,产妇年龄超过 35 岁(AOR=1.77,95%CI:1.34-2.33)、低出生体重(AOR=3.27,95%CI:2.16-4.94)、产前检查次数少于 4 次(AOR=1.12,95%CI:1.01-1.33)、剖宫产分娩(AOR=1.81,95%CI:1.30-2.54)、妊娠期间无任何并发症(AOR=0.76,95%CI:0.61-0.94)和社区贫困(AOR=1.32,95%CI:1.05-1.65)与早期新生儿死亡显著相关。

结论

本研究发现,撒哈拉以南非洲地区每 1000 例活产儿中约有 23 例新生儿在生命的第一周内死亡。在制定针对撒哈拉以南非洲地区早期新生儿死亡率的政策和战略时,应考虑母亲年龄、出生体重、产前护理服务利用情况、分娩方式、多胎妊娠、妊娠并发症和社区贫困等因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e201/11161111/ae093687fad0/pone.0304065.g001.jpg

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