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埃塞俄比亚奥罗米亚州西南绍阿地区公立医院分娩中死产的决定因素:一项病例对照研究

Determinants of Stillbirth Among Deliveries Attended at Public Hospitals of Southwest Shoa Zone, Oromia, Ethiopia: A Case-Control Study.

作者信息

Alayu Bereket Abebe, Balla EliasTeferi, Fekene Daniel Belema, Namara Galana Takele, Fekadu Marta

机构信息

Oromia Health Bureau Addis Ababa Ethiopia.

College of Medicine and Health Science Ambo University Ambo Ethiopia.

出版信息

Health Sci Rep. 2025 Apr 29;8(5):e70806. doi: 10.1002/hsr2.70806. eCollection 2025 May.

Abstract

BACKGROUND

During the past 20 years, there have been 48 million stillbirths worldwide. One of the most common adverse pregnancy outcomes in developing nations, such as Ethiopia, is stillbirth.

AIM

The aim of this study was to determine the factors that contribute to stillbirths among babies born in Ethiopia's Southwest Shoa Zone.

METHODS

Three hundred and two research participants were included in the hospital-based unmatched case-control study. The data extraction checklist was used to collect data from the medical records. To identify the determinants of stillbirth, bivariate and multivariate logistic regression analyses were used. The determinants of the stillbirth were identified in the multivariate logistic regression analysis with a -value of less than 0.05% and 95% CI.

RESULTS

A total of 302 maternal charts were reviewed, yielding a 100% response rate. Pre-eclampsia/eclampsia (AOR: 3.3, 95% CI: 1.2-9.2), antepartum hemorrhage (AOR: 5.8, 95% CI: 2.1-15.9), a referral from other health facilities (AOR: 2.8, 95% CI: 1.4-5.3), obstructed labor (AOR: 3.8, 95% CI: 1.9-7.8), duration of labor > 24 h. (AOR: 4.7, 95% CI: 2.3-9.6), gestational age < 37 weeks (AOR: 3.5, 95% CI: 1.7-7.4) and congenital defect (AOR: 6.9, 95% CI: 2.4-19.7) were determinants of still birth.

CONCLUSION

This study highlights that obstetric complications, gestational age, congenital abnormalities, and low birth weight were determinants of stillbirth. Addressing these challenges requires early identification and management of high-risk pregnancies through enhanced prenatal screening, strengthening antenatal care services, promoting facility-based deliveries, and equipping healthcare providers with skills to manage complications.

摘要

背景

在过去20年中,全球有4800万死产儿。在埃塞俄比亚等发展中国家,死产是最常见的不良妊娠结局之一。

目的

本研究的目的是确定埃塞俄比亚西南部绍阿地区出生婴儿中导致死产的因素。

方法

302名研究参与者纳入了这项基于医院的非匹配病例对照研究。使用数据提取清单从医疗记录中收集数据。为了确定死产的决定因素,采用了二元和多因素逻辑回归分析。在多因素逻辑回归分析中,以P值小于0.05%和95%置信区间确定死产的决定因素。

结果

共审查了302份产妇病历,回复率为100%。先兆子痫/子痫(比值比:3.3,95%置信区间:1.2 - 9.2)、产前出血(比值比:5.8,95%置信区间:2.1 - 15.9)、来自其他医疗机构的转诊(比值比:2.8,95%置信区间:1.4 - 5.3)、产程梗阻(比值比:3.8,95%置信区间:1.9 - 7.8)、产程持续时间>24小时(比值比:4.7,95%置信区间:2.3 - 9.6)、孕周<37周(比值比:3.5,95%置信区间:1.7 - 7.4)和先天性缺陷(比值比:6.9,95%置信区间:2.4 - 19.7)是死产的决定因素。

结论

本研究强调产科并发症、孕周、先天性异常和低出生体重是死产的决定因素。应对这些挑战需要通过加强产前筛查、强化产前护理服务、促进住院分娩以及使医疗保健提供者具备管理并发症的技能,尽早识别和管理高危妊娠。

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