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埃塞俄比亚亚的斯亚贝巴市卫生局下属选定公立医院新生儿重症监护病房收治的新生儿出生窒息及相关因素:一项横断面研究。

Neonatal birth asphyxia and associated factors among newborns delivered and admitted to NICU in selected public hospitals, under Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia, A cross-sectional study.

机构信息

Research Department, Gandhi Memorial Hospital, Addis Ababa, Ethiopia.

Department of Nursing, School of Health Sciences, Ambo University Woliso Campus, Woliso, Ethiopia.

出版信息

Ital J Pediatr. 2024 Sep 18;50(1):181. doi: 10.1186/s13052-024-01761-3.

Abstract

BACKGROUND

In developing countries birth asphyxia is a major cause of neonatal morbidity and mortality. Despite the implementation of various strategies and interventions to combat neonatal mortality rates, birth asphyxia remains the main public health concern in Ethiopia. Moreover, limited studies have been conducted, especially in the study area and there are no multicenter analyses available to generate evidence for action. Therefore, this study aimed to assess the burden and associated factors of birth asphyxia among newborns in the selected public hospitals of the Addis Ababa City Administration Health Bureau.

METHODS

Three hundred forty-three mother-child pairs who used delivery services and gave birth in the selected public hospitals were included in the study, and institution based cross sectional study design was employed. A systematic random sampling technique was used to select the study participants. A pretested, structured interviewer administered questionnaire was used to collect the data. The physician's/health care professionals diagnosis of an Apgar score less than 7 within the first five minutes of life led to the confirmation of the diagnosis of birth asphyxia. SPSS version 24 was used for analysis after the data were exported from Epi Info version 7.2. Multivariate logistic regression analysis included variables which had P-values less than 0.25 in the bivariable logistic regression analysis. The study findings were expressed using adjusted odds ratio with a 95% confidence interval, and P-value less than 0.05 was used to declare the statistical significance.

RESULTS

The magnitude of birth asphyxia was found to be 17.1% [95% CI; (13.2-21.5)] at the first 5 min. In the multivariable logistic regression analysis cord accident [AOR = 6.24: 95% CI; (1.24-31.32)], prolonged duration of labor [AOR = 2.49: 95% CI; (1.93-10.89)], and meconium-stained amniotic fluid [AOR = 3.33: 95% CI; (1.73-6.41)] were the predictors of birth asphyxia.

CONCLUSIONS

The findings of this research indicate that birth asphyxia is a prevalent neonatal problem at the study area. Therefore, the Addis Ababa Health Bureau must prioritize integrated mitigation interventions targeting high-risk pregnancies to achieve national and international commitment to sustainable changes in newborn health.

摘要

背景

在发展中国家,出生窒息是新生儿发病率和死亡率的主要原因。尽管实施了各种战略和干预措施来降低新生儿死亡率,但出生窒息仍然是埃塞俄比亚主要的公共卫生关注点。此外,尽管已经进行了有限的研究,特别是在研究区域,但没有多中心分析来提供行动证据。因此,本研究旨在评估选定的亚的斯亚贝巴市卫生局公立医院中新生儿出生窒息的负担和相关因素。

方法

本研究纳入了 343 对使用分娩服务并在选定的公立医院分娩的母婴对,采用基于机构的横断面研究设计。采用系统随机抽样技术选择研究参与者。使用经过预测试的、由访谈员管理的问卷收集数据。医生/医疗保健专业人员在生命最初 5 分钟内诊断出 Apgar 评分低于 7,即可确诊为出生窒息。数据从 Epi Info 版本 7.2 导出后,使用 SPSS 版本 24 进行分析。多变量逻辑回归分析包括在单变量逻辑回归分析中 P 值小于 0.25 的变量。研究结果用调整后的优势比(95%置信区间)表示,P 值小于 0.05 表示具有统计学意义。

结果

在最初的 5 分钟内,出生窒息的发生率为 17.1%[95%CI;(13.2-21.5)]。在多变量逻辑回归分析中,脐带意外[AOR=6.24:95%CI;(1.24-31.32)]、延长的产程[AOR=2.49:95%CI;(1.93-10.89)]和胎粪污染的羊水[AOR=3.33:95%CI;(1.73-6.41)]是出生窒息的预测因素。

结论

本研究结果表明,出生窒息是研究区域新生儿的一个普遍问题。因此,亚的斯亚贝巴卫生局必须优先考虑针对高危妊娠的综合缓解干预措施,以实现国家和国际对新生儿健康可持续变革的承诺。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ceb/11409611/d6d6af153bf7/13052_2024_1761_Fig1_HTML.jpg

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