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埃塞俄比亚西北部围产期窒息新生儿低血糖复发情况及相关因素:多中心回顾性随访研究与负二项回归分析

Recurrence of hypoglycaemia and associated factors among neonates admitted with perinatal asphyxia in Northwest Ethiopia: multicentre, retrospective follow-up study with negative binomial regression.

作者信息

Gedefaw Gezahagn Demsu, Asmare Temesgen Brilie, Abate Asnake Tadesse, Wondie Wubet Tazeb, Ayenew Mulugeta Endalamaw, Bazezew Astewil Moges, Siyoum Tsehayu Melak, Worku Degalem Tilahun, Endeshaw Yaregal Semanew

机构信息

Department of Neonatal Health Nursing, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia

Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMJ Open. 2025 Apr 5;15(4):e096158. doi: 10.1136/bmjopen-2024-096158.

Abstract

OBJECTIVE

To estimate the recurrence of hypoglycaemia and the associated factors in neonates with birth asphyxia admitted to the neonatal intensive care unit in Northwest Amhara region's comprehensive specialised hospitals, Northwest Ethiopia, in 2024.

DESIGN

A multicentre, institution-based, retrospective follow-up study.

SETTING

Tertiary hospitals in Northwest Amhara Regional State, Northwest Ethiopia, from 1 July 2020 to 30 July 2024.

PARTICIPANTS

A total of 761 neonates with perinatal asphyxia were admitted to the neonatal intensive care unit of selected public hospitals in Northwest Amhara from July 2020 to July 2024.

OUTCOME MEASURE

The primary outcome measure of this study was recurrence of hypoglycaemia. Furthermore, the factors associated with recurrence of hypoglycaemia in newborns with perinatal asphyxia were noted.

RESULTS

The average number of hypoglycaemia cases among neonates with birth asphyxia was 2.05 (95% CI 1.939, 2.163) over the 28-day follow-up period. Meningitis (adjusted incidence rate ratio (AIRR)=1.16; 95% CI 1.04, 1.30), feeding in less than 72 hours (AIRR=1.17; 95% CI 1.05, 1.31), stage 3 hypoxic-ischaemic injury (AIRR=1.20; 95% CI 1.04, 1.39), length of hospital stay (AIRR=1.01; 95% CI 1.01, 1.03) and macrosomia (AIRR=1.39; 95% CI 1.19, 1.63) were significant factors associated with recurrence of hypoglycaemia.

CONCLUSIONS AND RECOMMENDATIONS

The current study indicated that the mean recurrence of hypoglycaemia in newborns experiencing perinatal asphyxia was considerably higher. Presence of neonatal meningitis, delayed initiation of feeding 72 hours after birth, stage 3 hypoxic-ischaemic injury, length of hospital stay and macrosomia were the key factors associated with recurrence of hypoglycaemia.

摘要

目的

评估2024年埃塞俄比亚西北部阿姆哈拉地区综合专科医院新生儿重症监护病房收治的出生窒息新生儿低血糖复发情况及相关因素。

设计

一项多中心、基于机构的回顾性随访研究。

地点

埃塞俄比亚西北部阿姆哈拉地区州的三级医院,时间为2020年7月1日至2024年7月30日。

参与者

2020年7月至2024年7月期间,共有761例围产期窒息新生儿入住阿姆哈拉地区西北部选定公立医院的新生儿重症监护病房。

观察指标

本研究的主要观察指标是低血糖复发情况。此外,还记录了围产期窒息新生儿低血糖复发的相关因素。

结果

在28天的随访期内,出生窒息新生儿低血糖病例的平均数量为2.05(95%可信区间1.939,2.163)。脑膜炎(调整发病率比(AIRR)=1.16;95%可信区间1.04,1.30)、出生后72小时内开始喂养(AIRR=1.17;95%可信区间1.05,1.31)、3期缺氧缺血性损伤(AIRR=1.20;95%可信区间1.04,1.39)、住院时间(AIRR=1.01;95%可信区间1.01,1.03)和巨大儿(AIRR=1.39;95%可信区间1.19,1.63)是与低血糖复发相关的显著因素。

结论与建议

当前研究表明,经历围产期窒息的新生儿低血糖平均复发率相当高。新生儿脑膜炎的存在、出生后72小时后延迟开始喂养、3期缺氧缺血性损伤、住院时间和巨大儿是与低血糖复发相关的关键因素。

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