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低收入和中等收入国家孕妇非传染性疾病及母婴结局剖析:一项描述性横断面研究

Unravelling non-communicable diseases among pregnant women in a lower-middle-income country and the feto-maternal outcomes: a descriptive cross-sectional study.

作者信息

Matthias Anne Thushara, Ranaweera Probhodana, Abeysinghe Hiruni, Prathapan R, Marious Shanilka, Jayawardena Madura, Herath Rasika, Fernandopulle Rukshan Cleophas, Fernando Ajith, Silva Dhammike, Chamara Shameera Ruwan, Prathapan Shamini

机构信息

University of Sri Jayewardenepura Faculty of Medical Sciences, Nugegoda, Sri Lanka

Department of Obstetrics and Gynecology, University of Colombo Faculty of Medicine, Colombo, WP, Sri Lanka.

出版信息

BMJ Open. 2025 Jul 28;15(7):e098178. doi: 10.1136/bmjopen-2024-098178.

Abstract

OBJECTIVES

This study aimed to determine the prevalence of non-communicable diseases (NCDs) among pregnant women in Sri Lanka and examine the association between NCDs and maternal and fetal outcomes.

DESIGN

A hospital-based, descriptive cross-sectional study.

SETTING

The study was conducted in three tertiary care hospitals in the Western Province and one intermediate obstetrics care facility in the Southern Province of Sri Lanka, encompassing diverse, multiethnic populations, over 3 months.

PARTICIPANTS

Data from 1350 pregnant women were collected from discharged bed head tickets of the postnatal obstetric wards using a standardised checklist.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes were the prevalence of NCDs. Secondary outcomes included associations between maternal NCDs and adverse fetal outcomes such as preterm births and neonatal complications.

RESULTS

Among the participants, 68.5% (n=926) had one or more NCDs, with anaemia (37.9%), obesity (18.1%), gestational diabetes mellitus (14.9%) and hypertensive disorders (13.6%) being the most prevalent. Women with NCDs were at significantly higher odds of adverse fetal outcomes, including preterm birth (OR=2.3, 95% CI: 1.5 to 3.4), neonatal sepsis (OR=2.5, 95% CI: 1.5 to 4.04) and hypoglycaemia (OR=3.5, 95% CI: 1.2 to 10.0). Maternal complications, including postpartum haemorrhage (3.3%) and placental abruption (0.7%), were also more frequent in this group.

CONCLUSIONS

NCDs are highly prevalent among pregnant women in Sri Lanka and are significantly associated with adverse maternal and fetal outcomes. Enhanced screening and management strategies during antenatal care are essential to mitigate risks and improve health outcomes, aligning with global efforts to reduce maternal and neonatal morbidity and mortality.

摘要

目的

本研究旨在确定斯里兰卡孕妇中非传染性疾病(NCDs)的患病率,并探讨非传染性疾病与孕产妇和胎儿结局之间的关联。

设计

一项基于医院的描述性横断面研究。

背景

该研究在斯里兰卡西部省的三家三级护理医院和南部省的一家中级产科护理机构进行,为期3个月,涵盖了不同的多民族人群。

参与者

使用标准化检查表从产后产科病房出院床头票中收集了1350名孕妇的数据。

主要和次要结局指标

主要结局是非传染性疾病的患病率。次要结局包括孕产妇非传染性疾病与早产和新生儿并发症等不良胎儿结局之间的关联。

结果

在参与者中,68.5%(n = 926)患有一种或多种非传染性疾病,其中贫血(37.9%)、肥胖(18.1%)、妊娠期糖尿病(14.9%)和高血压疾病(13.6%)最为常见。患有非传染性疾病的妇女出现不良胎儿结局的几率显著更高,包括早产(OR = 2.3,95%CI:1.5至3.4)、新生儿败血症(OR = 2.5,95%CI:1.5至4.04)和低血糖(OR = 3.5,95%CI:1.2至10.0)。该组中孕产妇并发症,包括产后出血(3.3%)和胎盘早剥(0.7%)也更为常见。

结论

非传染性疾病在斯里兰卡孕妇中高度流行,并且与不良孕产妇和胎儿结局显著相关。加强产前护理期间的筛查和管理策略对于降低风险和改善健康结局至关重要,这与全球减少孕产妇和新生儿发病率及死亡率的努力相一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc1/12306243/bba6a259edaf/bmjopen-15-7-g001.jpg

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