Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria.
Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
BJOG. 2024 Aug;131 Suppl 3:20-29. doi: 10.1111/1471-0528.17864. Epub 2024 Jun 10.
To determine the prevalence of maternal morbidity and death from pregnancy loss before 28 weeks in referral-level hospitals in Nigeria.
Secondary analysis of a nationwide cross-sectional study.
Fifty-four referral-level hospitals.
Women admitted for complications arising from pregnancy loss before 28 weeks between 1 September 2019 to 31 August 2020.
Frequency and type of pregnancy loss were calculated using the extracted data. Multilevel logistic regression was used to determine sociodemographic and clinical factors associated with early pregnancy loss. Factors contributing to death were also analysed.
Prevalence and outcome of pregnancy loss at <28 weeks; sociodemographic and clinical predictors of morbidity after early pregnancy loss; contributory factors to death.
Of the 4798 women who had pregnancy loss at <28 weeks of pregnancy, spontaneous abortion accounted for 49.2%, followed by missed abortion (26.9%) and ectopic pregnancy (15%). Seven hundred women (14.6%) had a complication following pregnancy loss and 99 women died (2.1%). Most complications (26%) and deaths (7%) occurred after induced abortion. Haemorrhage was the most frequent complication in all types of pregnancy loss with 11.5% in molar pregnancy and 6.9% following induced abortion. Predictors of complication or death were low maternal education, husband who was not gainfully employed, grand-multipara, pre-existing chronic medical condition and referral from another facility or informal setting.
Pregnancy loss before 28 weeks is a significant contributor to high maternal morbidity and mortality in Nigeria. Socio-economic factors and delays in referral to higher levels of care contribute significantly to poor outcomes for women.
确定尼日利亚转诊医院 28 周前妊娠丢失导致的产妇发病率和死亡率。
全国性横断面研究的二次分析。
54 家转诊医院。
2019 年 9 月 1 日至 2020 年 8 月 31 日期间因 28 周前妊娠丢失并发症入院的妇女。
使用提取的数据计算妊娠丢失的频率和类型。多水平逻辑回归用于确定与早期妊娠丢失相关的社会人口学和临床因素。还分析了导致死亡的因素。
<28 周的妊娠丢失的发生率和结局；早期妊娠丢失后发病率的社会人口学和临床预测因素；导致死亡的因素。
在 4798 名 28 周前妊娠丢失的妇女中，自然流产占 49.2%，其次是稽留流产（26.9%）和异位妊娠（15%）。700 名妇女（14.6%）在妊娠丢失后出现并发症，99 名妇女死亡（2.1%）。大多数并发症（26%）和死亡（7%）发生在人工流产后。所有类型的妊娠丢失中最常见的并发症是出血，葡萄胎为 11.5%，人工流产后为 6.9%。并发症或死亡的预测因素是产妇受教育程度低、丈夫无业、多产妇、既往慢性疾病以及从其他医疗机构或非正式场所转诊。
28 周前的妊娠丢失是导致尼日利亚产妇发病率和死亡率高的重要原因。社会经济因素以及向更高水平医疗机构的转诊延迟对妇女的结局有重大影响。
