Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals.
Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals.
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DOI：
10.1016/j.eclinm.2022.101411
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发表时间：
2022-05
影响因子：
15.1
通讯作者：
中科院分区：
文献类型：
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作者：
世卫组织与尼日利亚联邦卫生部合作，在转诊级医院之间建立了一个全国性电子数据平台。我们报告了第一年产妇、胎儿和新生儿并发症的负担以及护理的质量和结果。该研究分析了2019年9月至2020年8月期间，54家医院76,563名因分娩或分娩后42天内出现并发症或终止妊娠而入院的妇女的数据，这些医院包括在孕产妇和围产期质量、公平和尊严数据库方案中。参与医院报告了69 055例活产、4 498例死产和1 090例新生儿早期死亡。44,614名妇女（58.3%）至少有一种妊娠并发症，其中6,618名妇女（8.6%）符合我们的潜在危及生命的并发症标准，940名妇女（1.2%）死亡。产妇死亡的主要原因是子痫（n = 187, 20.6%）、产后出血（n = 103, 11.4%）和败血症（n = 99, 10.8%）。产前缺氧（n = 1455, 31.1%）和急性产时事件（n = 913, 19.6%）是围产儿死亡的主要原因。产妇和围产期死亡的预测因素相似：产妇教育程度低、缺乏产前护理、从其他机构转诊、既往剖腹产、潜伏期分娩入院、手术阴道分娩、未使用分娩监测工具、无分娩伴产、未使用子宫强直剂预防PPH。这一全国性的常规数据汇总方案表明，尼日利亚降低孕产妇和围产期死亡率的战略需要采取多部门办法。通过解决主要的死亡预测因素，包括在国际推荐的干预措施（如劳动陪伴和使用劳动监测工具）的覆盖范围方面的差距，可以在短期内挽救若干人的生命。这项工作由MSD for Mothers资助；开发计划署/人口基金/儿童基金会/卫生组织/世界银行人类生殖研究、发展和研究培训特别方案，这是一个由世界卫生组织（卫生组织）共同发起的方案。
The WHO in collaboration with the Nigeria Federal Ministry of Health, established a nationwide electronic data platform across referral-level hospitals. We report the burden of maternal, foetal and neonatal complications and quality and outcomes of care during the first year. Data were analysed from 76,563 women who were admitted for delivery or on account of complications within 42 days of delivery or termination of pregnancy from September 2019 to August 2020 across the 54 hospitals included in the Maternal and Perinatal Database for Quality, Equity and Dignity programme. Participating hospitals reported 69,055 live births, 4,498 stillbirths and 1,090 early neonatal deaths. 44,614 women (58·3%) had at least one pregnancy complication, out of which 6,618 women (8·6%) met our criteria for potentially life-threatening complications, and 940 women (1·2%) died. Leading causes of maternal death were eclampsia (n = 187,20·6%), postpartum haemorrhage (PPH) (n = 103,11·4%), and sepsis (n = 99,10·8%). Antepartum hypoxia (n = 1455,31·1%) and acute intrapartum events (n = 913,19·6%) were the leading causes of perinatal death. Predictors of maternal and perinatal death were similar: low maternal education, lack of antenatal care, referral from other facility, previous caesarean section, latent-phase labour admission, operative vaginal birth, non-use of a labour monitoring tool, no labour companion, and non-use of uterotonic for PPH prevention. This nationwide programme for routine data aggregation shows that maternal and perinatal mortality reduction strategies in Nigeria require a multisectoral approach. Several lives could be saved in the short term by addressing key predictors of death, including gaps in the coverage of internationally recommended interventions such as companionship in labour and use of labour monitoring tool. This work was funded by MSD for Mothers; and UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO).
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DOI：
10.1111/1471-0528.16913
发表时间：
2022-03
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
--
作者：
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DOI：
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发表时间：
2012-04-01
影响因子：
3.8
作者：
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影响因子：
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DOI：
10.1016/j.bpobgyn.2009.01.007
发表时间：
2009-06-01
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DOI：
10.1111/1471-0528.12395
发表时间：
2013-12-01
影响因子：
5.8
作者：
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