Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: a prospective study
Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: a prospective study
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DOI：
10.1186/s12884-017-1280-1
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发表时间：
2017-03-28
影响因子：
3.1
通讯作者：
Wright, Linda L.
中科院分区：
文献类型：
--
作者：
Anggondowati, Trisari;El-Mohandes, Ayman A. E.;Wright, Linda L.
背景资料：我们调查了产妇的特点，获得护理，产科并发症，包括近错过状态入院或住院期间对围产期outcome. Methods之间的关联印尼singletons.Methods：我们前瞻性地收集了在东爪哇省的两家医院的先天性单胎的数据。数据包括社会人口统计学、生殖、产科和新生儿变量。构建了简化的多变量模型。关注的结局包括低和极低出生体重（LBW/VLBW）、窒息和死亡。从护理机构转诊与LBW和VLBW [AOR = 0.28，95%CI = 0.11-0.69，AOR = 0.18，95%CI = 0.04-0.75]、死产[AOR = 0.41，新生儿死亡[AOR = 0.2，95%CI = 0.05-0.81]。母亲年龄< 20岁可增加VLBW [ AOR = 6.39，95%CI = 1.82-22.35]和新生儿死亡[AOR = 4.10，95%CI = 1.29-13.02]的风险。入院时胎位不正增加了窒息[AOR = 4.65，95%CI = 2.23-9.70]、死产[AOR = 3.96，95%CI = 1.41-11.15]和围产期死亡[AOR = 3.89，95%CI = 1.42-10.64]的风险，产前护理不良（PNC）[AOR = 11.67，95%CI = 2.71-16.62]。入院时漏诊可增加新生儿[AOR = 11.67，95%CI = 2.08-65.65]和围产儿死亡[AOR = 13.08，95%CI = 3.77-45.37]的风险。结论：应鼓励临产母亲及早就医，并教育其识别早期危险信号。适当的产前护理大大减少了围产期死亡。改善医院对胎位不正的管理可能会显着降低围产期发病率和死亡率。医院为基础的前瞻性研究的重要性，有助于评估具体领域的需要在培训产科护理提供者。
Background: We investigated associations between maternal characteristics, access to care, and obstetrical complications including near miss status on admission or during hospitalization on perinatal outcomes among Indonesian singletons.Methods: We prospectively collected data on inborn singletons at two hospitals in East Java. Data included socio-demographics, reproductive, obstetric and neonatal variables. Reduced multivariable models were constructed. Outcomes of interest included low and very low birthweight (LBW/VLBW), asphyxia and death.Results: Referral from a care facility was associated with a reduced risk of LBW and VLBW [AOR = 0.28, 95% CI = 0.11-0.69, AOR = 0.18, 95% CI = 0.04-0.75, respectively], stillbirth [AOR = 0.41, 95% CI = 0.18-0.95], and neonatal death [AOR = 0.2, 95% CI = 0.05-0.81]. Mothers age < 20 years increased the risk of VLBW [ AOR = 6.39, 95% CI = 1.82-22.35] and neonatal death [AOR = 4.10, 95% CI = 1.29-13.02]. Malpresentation on admission increased the risk of asphyxia [AOR = 4.65, 95% CI = 2.23-9.70], stillbirth [AOR = 3.96, 95% CI = 1.41-11.15], and perinatal death [AOR = 3.89 95% CI = 1.42-10.64], as did poor prenatal care (PNC) [AOR = 11.67, 95% CI = 2.71-16.62]. Near-miss on admission increased the risk of neonatal [AOR = 11.67, 95% CI = 2.08-65.65] and perinatal death [AOR = 13.08 95% CI = 3.77-45.37].Conclusions: Mothers in labor should be encouraged to seek care early and taught to identify early danger signs. Adequate PNC significantly reduced perinatal deaths. Improved hospital management of malpresentation may significantly reduce perinatal morbidity and mortality. The importance of hospital-based prospective studies helps evaluate specific areas of need in training of obstetrical care providers.