Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence from a large-scale community-based clinical trial
Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence from a large-scale community-based clinical trial
复制标题
DOI：
10.1111/j.1365-3016.2006.00752.x
复制
发表时间：
2006-11-01
影响因子：
2.8
通讯作者：
Khatun, Mohsina
中科院分区：
文献类型：
--
作者：
Al Mamun, Abdullah;Padmadas, Sabu S.;Khatun, Mohsina
孟加拉国的围产期死亡率很高。在这种情况下，很少有社区一级的研究评估了潜在的孕产妇健康因素对围产期结局的影响。我们使用1994年至1997年在孟加拉国达卡郊区米尔布尔的一家大型妇幼保健/计划生育医院的集水区进行的一项以社区为基础的临床对照试验的数据，调查围产儿死亡率及其相关的孕产妇健康因素。或者直到他们退出研究。其中，1584谁生了形成我们的研究对象。在研究人群中，死产率为39.1/1000例分娩[95%置信区间（CI）39.0，39.3]，围产期死亡率（最多3天）为54.3/1000例分娩[95% CI 54.0，54.6]。在完全校正的logistic回归模型中，高血压疾病妇女的围产期死亡风险高达2.7倍[95%CI 1.5，4.9]，产前出血妇女的围产期死亡风险为5.0倍[95%CI 2.3，10.8]，产前出血妇女的围产期死亡风险为2.6倍[95%CI 1.2，5.8]对于怀孕期间血红蛋白水平较高的女性来说，与同龄人相比，这一数字同样高。包括潜在的混杂变量，如产科病史差，社会人口学特征和早产的影响，只有轻微的净效应的重要孕产妇健康因素与围产期mortaris. The围产期死亡率在研究设置显着相关的孕产妇健康状况差，在怀孕期间。这项研究的结果表明，迫切需要监测高危妊娠的并发症，要求安全孕产方案干预措施的具体组成部分旨在管理这些妊娠并发症。
Perinatal mortality is very high in Bangladesh. In this setting, few community-level studies have assessed the influence of underlying maternal health factors on perinatal outcomes. We used the data from a community-based clinical controlled trial conducted between 1994 and 1997 in the catchment areas of a large MCH/FP hospital located in Mirpur, a suburban area of Dhaka in Bangladesh, to investigate the levels of perinatal mortality and its associated maternal health factors during pregnancy.A total of 2007 women were followed after recruitment up to delivery, maternal death, or until they dropped out of the study. Of these, 1584 who gave birth formed our study subjects. The stillbirth rate was 39.1 per 1000 births [95% confidence interval (CI) 39.0, 39.3] and the perinatal mortality rate (up to 3 days) was 54.3 per 1000 births [95% CI 54.0, 54.6] among the study population. In the fully adjusted logistic regression model, the risk of perinatal mortality was as high as 2.7 times [95% CI 1.5, 4.9] more likely for women with hypertensive disorders, 5.0 times [95% CI 2.3, 10.8] as high for women who had antepartum haemorrhage and 2.6 times [95% CI 1.2, 5.8] as high for women who had higher haemoglobin levels in pregnancy when compared with their counterparts. The inclusion of potential confounding variables such as poor obstetric history, sociodemographic characteristics and preterm delivery influenced only marginally the net effect of important maternal health factors associated with perinatal mortality.Perinatal mortality in the study setting was significantly associated with poor maternal health conditions during pregnancy. The results of this study point towards the urgent need for monitoring complications in high-risk pregnancies, calling for the specific components of the safe motherhood programme interventions that are designed to manage these complications of pregnancy.