Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania.
Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania.
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DOI：
10.1186/1471-2393-11-68
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发表时间：
2011-10-04
影响因子：
3.1
通讯作者：
Daltveit AK
中科院分区：
文献类型：
--
作者：
Mmbaga BT;Lie RT;Kibiki GS;Olomi R;Kvåle G;Daltveit AK
在包括坦桑尼亚在内的许多低收入国家，新生儿死亡率的下降慢于预期。适当的新生儿护理可能有助于降低死亡率。我们在坦桑尼亚乞力马扎罗基督教医疗中心(KCMC)的出生登记数据中研究了与将婴儿转移到新生儿护理病房(NCU)相关的因素。在2000年至2008年期间登记的单身活产婴儿共有21 206名。采用多因素分析研究社会人口学因素、妊娠并发症、新生儿状况等因素对新生儿转入新生儿监护室的影响。共有3190名(15%)新生儿独生子女被转移到NCU。正如预期的那样，新生儿转移与婴儿的具体情况密切相关，包括出生体重大于4000g(相对危险度(RR)=7.2；95%可信区间(CI)6.5-8.0)或小于1500g(RR=3.0；95%CI：2.3-4.0)、5分钟Apgar评分小于7(RR=4.0；95%CI：3.4-4.6)、34周前早产(RR=1.8；95%CI：1.5-2.1)。然而，与妊娠和分娩相关的情况，如胎膜早破(RR=2.3；95%CI：1.9~2.7)、子痫前期(RR=1.3；95%CI：1.1~1.5)、其他阴道分娩(RR=2.2；95%CI：1.7~2.9)和剖宫产(RR=1.9；95%CI：1.8~2.1)也与移植显著相关。出生第一个孩子与转移的可能性增加相关(相对风险(RR)1.4；95%可信区间：1.2-1.5)，而当父亲没有受过教育时，转移的可能性降低(RR=0.5；95%可信区间：0.3-0.9)。除了新生儿转移与发病率和死亡率的经典新生儿危险因素之间的强烈关联外，一些与怀孕有关的人口因素也是新生儿转移的预测因素。总体而言，健康状况不佳或怀孕复杂的婴儿更有可能被转移。除了没有受过教育的父亲的婴儿的转移率可能减少，以及第一个出生的婴儿的转移率较高外，没有迹象表明转移率是基于非医学适应症。
Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU) in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn. A total of 3190 (15%) newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR) = 7.2; 95% confidence interval (CI) 6.5-8.0) or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0), five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6), and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1). However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7), preeclampsia (RR = 1.3; 95% CI: 1.1-1.5), other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9) and caesarean section (RR = 1.9; 95% CI: 1.8-2.1) were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR) 1.4; 95% CI: 1.2-1.5), while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9) when the father had no education. In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer for babies of non-educated fathers and a high transfer rate for first born babies, there were no signs that transfer was based on non-medical indications.
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影响因子：
7.7
作者：
Cousens S;Blencowe H;Gravett M;Lawn JE
通讯作者：
Lawn JE
影响因子：
1.8
作者：
Chen, Minghua;McNiff, Ceara;Dammann, Olaf
通讯作者：
Dammann, Olaf
影响因子：
4.5
作者：
Elshibly, Eltahir M.;Schmalisch, Gerd
通讯作者：
Schmalisch, Gerd
DOI：
10.1016/0028-2243(93)90200-v
发表时间：
1993-08-01
期刊：
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY
影响因子：
--
作者：
BLONDEL, B;DUTILH, P;UZAN, S
通讯作者：
UZAN, S
影响因子：
9.8
作者：
Ehrenberg, HM;Mercer, BM;Catalano, PM
通讯作者：
Catalano, PM