埃塞俄比亚西北部南贡德尔地区医院分娩母亲中新发产后先兆子痫的决定因素：一项多中心病例对照研究
Determinants of new-onset postpartum preeclampsia among mothers who delivered in hospitals in the South Gondar Zone, Northwest Ethiopia: a multicenter case-control study.
作者信息
Addisu Dagne, Mitiku Yekaba, Yazie Ferede Wassie, Mekuriaw Begizew Yimenu, Erega Besfat Berihun, Bazezew Lakachew Yismaw, Belachew Tegegne Wale, Tadesse Selamawit Girma, Goshu Yitayal Ayalew, Mengistie Belaynew Alemye, Mekie Maru, Misker Agernesh Dereje, Mihretie Gedefaye Nibret
机构信息
Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Midwifery, Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2025 Feb 14;25(1):161. doi: 10.1186/s12884-025-07274-z.
BACKGROUND
New-onset postpartum preeclampsia has emerging as a significant public health concern in Ethiopia, with a notable increase in incidence in the study area. While substantial research exists on antepartum preeclampsia, data on the determinants of new-onset postpartum preeclampsia are limited. Therefore, this study aimed to investigate determinants of new-onset postpartum preeclampsia among mothers who gave birth at hospitals in the South Gondar Zone, Northwest Ethiopia.
METHODS
An unmatched case-control study was conducted with 355 postpartum mothers (89 cases and 266 controls). A multistage sampling method was used to select the study participants. Data were collected using structured questionnaires and medical chart reviews, and analyzed using SPSS Version 27. Binary logistic regression (bivariable and multivariable analysis) was used to identify factors associated with new-onset postpartum preeclampsia. Statistical significance was set at p < 0.05, and strength of associations were measured using adjusted odds ratios (AOR) with 95% confidence intervals (CIs).
RESULT
New-onset postpartum preeclampsia was significantly associated with several factors, including advanced maternal age, fewer antenatal care (ANC) visits, contraceptive use, physical inactivity, a history of multiple gestations, and gestational diabetes mellitus. Specifically, maternal age ≥ 40 years (AOR = 11.63, 95% CI: 4.24-31.86), fewer than four ANC visits (AOR = 8.45, 95% CI: 3.96-18.05), contraceptive use (AOR = 4.04, 95% CI: 1.26-13.37), irregular physical activity (AOR = 4.05, 95% CI: 1.32-12.44), physical inactivity (AOR = 8.25, 95% CI: 4.62-19.29), a history of multiple gestations (AOR = 2.66, 95% CI: 1.26-5.60), and gestational diabetes mellitus (AOR = 17.79, 95% CI: 7.72-40.95) were identified as key determinants.
CONCLUSIONS
Advanced maternal age, fewer ANC visits, contraceptive use, physical inactivity, multiple gestations, and gestational diabetes were strongly associated with new-onset postpartum preeclampsia. Increased ANC visits and postpartum monitoring are essential for early detection and management of postpartum preeclampsia. Additionally, promoting physical activity should be incorporated into maternal health strategies to reduce the incidence of new onset postpartum preeclampsia.
背景
新发产后子痫前期已成为埃塞俄比亚一个重大的公共卫生问题，研究区域内的发病率显著上升。虽然关于产前子痫前期已有大量研究，但关于新发产后子痫前期的决定因素的数据有限。因此，本研究旨在调查埃塞俄比亚西北部南贡德尔地区医院分娩的母亲中，新发产后子痫前期的决定因素。
方法
对355名产后母亲（89例病例和266例对照）进行了一项非匹配病例对照研究。采用多阶段抽样方法选择研究参与者。通过结构化问卷和病历审查收集数据，并使用SPSS 27版进行分析。采用二元逻辑回归（双变量和多变量分析）来确定与新发产后子痫前期相关的因素。统计学显著性设定为p < 0.05，并使用调整后的优势比（AOR）和95%置信区间（CI）来衡量关联强度。
结果
新发产后子痫前期与几个因素显著相关，包括高龄产妇、产前检查（ANC）次数较少、使用避孕药具、缺乏体育活动、多胎妊娠史和妊娠期糖尿病。具体而言，产妇年龄≥40岁（AOR = 11.63，95% CI：4.24 - 31.86）、ANC就诊次数少于4次（AOR = 8.45，95% CI：3.96 - 18.05）、使用避孕药具（AOR = 4.04, 95% CI：1.26 - 13.37）、不定期体育活动（AOR = 4.05，95% CI：1.32 - 12.44）、缺乏体育活动（AOR = 8.25，95% CI：4.62 - 19.29）、多胎妊娠史（AOR = 2.66，95% CI：1.26 - 5.60）和妊娠期糖尿病（AOR = 17.79，95% CI：7.72 - 40.95）被确定为关键决定因素。
结论
高龄产妇、ANC就诊次数较少、使用避孕药具、缺乏体育活动、多胎妊娠和妊娠期糖尿病与新发产后子痫前期密切相关。增加ANC就诊次数和产后监测对于产后子痫前期的早期发现和管理至关重要。此外，应将促进体育活动纳入孕产妇健康策略，以降低新发产后子痫前期的发病率。
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