Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria.
Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria.
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DOI：
10.11604/pamj.2016.24.1.8382
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Ryckman K
中科院分区：
文献类型：
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作者：
Butali A;Ezeaka C;Ekhaguere O;Weathers N;Ladd J;Fajolu I;Esezobor C;Makwe C;Odusanya B;Anorlu R;Adeyemo W;Iroha E;Egri-Okwaji M;Adejumo P;Oyeneyin L;Abiodun M;Badejoko B;Ryckman K
早产是一种可怕的妊娠并发症，给受影响的儿童、他们的家庭和卫生保健系统带来巨大的长期医疗和经济负担。本研究的目的是确定2011年至2013年在尼日利亚拉各斯的拉各斯大学教学医院（LUTH）与早产相关的特征。我们从分娩病房的5，561例产妇、胎儿/新生儿和产科记录中获得了信息。我们排除了小于22周的分娩（0.25%）、妊娠≥ 42周的过期分娩（1.3%）和未知妊娠（1.4%）。此外，我们排除了多胞胎（5.4%）和死产（8.3%）的记录，留下4，691例单胎活产记录进行分析。进行Logistic回归分析，比较早产（妊娠22 - 36周）与足月分娩（妊娠37 - 41周）。还评估了调整母亲年龄、产次、胎位、分娩方式和预约状态的多变量模型。使用多项式回归来确定与早产（PTB）相关的特征，所述早产被定义为早期PTB（妊娠22 - 31周）、中度PTB（妊娠32 - 34周）、晚期PTB（妊娠35 - 36周），与足月分娩（妊娠37 - 41周）相比。根据我们的数据，16.8%的单胎活产分娩是早产（<37周妊娠）。其中，4.7%为早期（22 - 31周），4.5%为中度（32 - 34周），7.7%为晚期（35 - 36周）PTB。高龄产妇（≥ 35岁）[比值比（OR）= 1.41]、高血压（OR = 3.44）和胎膜破裂（OR = 4.03）与PTB的几率增加显著相关。接受预防母婴传播艾滋病毒治疗的妇女患结核病的风险显著降低（OR = 0.70）。这一组中有16%的妇女没有在LUTH登记产前护理。这些未登记的受试者发生所有类型PTB的几率显著更高，包括早期（比值比（OR）= 20.8）、中度（OR = 8.68）和晚期（OR = 2.15）。尼日利亚的肺结核和肺结核风险仍然很高。我们建议任何高危妊娠都应转诊到三级产前护理中心，以显着减少不良出生结局，如PTB。
Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward. We excluded delivery at less than 22 weeks (0.25%), post-term birth at ≥42 weeks gestation (1.3%), and unknown gestation (1.4%). Additionally, we excluded records of multiple births (5.4%) and stillbirths (8.3%) leaving 4,691 records of singleton live-births for analysis. Logistic regression analysis was performed comparing preterm birth (22-36 weeks gestation) to term birth (37-41 weeks gestation). Multiple variable models adjusting for maternal age, parity, fetal position, delivery method and booking status were also evaluated. Multinomial regression was used to identify characteristics associated with preterm birth (PTB) defined as early PTB (22-31 weeks gestation), moderate PTB (32-34 weeks gestation), late PTB (35-36 weeks gestation), compared to term birth (37-41 completed weeks gestation). From our data, 16.8% of the singleton live-birth deliveries were preterm (<37 weeks gestation). Of these, 4.7% were early (22-31 weeks), 4.5% were moderate (32-34 weeks) and 7.7% were late (35-36) PTBs. Older maternal age (≥35 years) [odds ratio (OR) = 1.41], hypertension (OR = 3.44) and rupture of membranes (OR = 4.03) were significantly associated with increased odds of PTB. Women being treated for the prevention of mother-to-child transmission of HIV were at a significantly decreased risk for PTB (OR = 0.70). Sixteen percent of women in this cohort were not registered for antenatal care in LUTH. These non-registered subjects had significantly greater odds of all categories of PTB, including early (odds ratio (OR) = 20.8), moderate (OR = 8.68), and late (OR = 2.15). PTB and risks for PTB remain high in Nigeria. We recommend that any high risk pregnancy should be referred to a tertiary center for prenatal care in order to significantly reduce adverse birth outcomes such as PTBs.