Perinatal Mortality in Eastern Uganda: A Community Based Prospective Cohort Study
Perinatal Mortality in Eastern Uganda: A Community Based Prospective Cohort Study
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DOI：
10.1371/journal.pone.0019674
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发表时间：
2011-05-09
期刊：
影响因子：
3.7
通讯作者：
Sommerfelt, Halvor
中科院分区：
文献类型：
--
作者：
Nankabirwa, Victoria;Tumwine, James K.;Sommerfelt, Halvor
背景资料：为了按照千年发展目标4降低儿童死亡率，必须大幅降低新生儿死亡率。我们报告死产和早期新生儿死亡的风险，以及围产期死亡率的决定因素在EasternUgand.Methods：一个以社区为基础的前瞻性队列研究，在2006年和2008年之间进行。共对835名孕妇进行了随访，以了解妊娠结局和分娩后7天内子女的存活情况。母亲的居住地，年龄，产次，蚊帐的使用和是否发生在家里进行了多变量回归分析，以确定围产儿death.Results的危险因素：死产的风险是19每1,000例妊娠和早期新生儿死亡的风险22每1,000例活产。总体而言，围产期死亡风险为41 [95%CI：27，54]/1,000例妊娠。在死亡病例中，47%是难产，24%是早产。围产期死亡率为63/1，000例怀孕的少女母亲，76/1，000例怀孕的初产妇和61/1，000例怀孕的妇女在家里分娩，在控制潜在的混杂因素后，有3.7（95%CI：1.8，7.4）倍高围产期死亡率比妇女在卫生设施分娩。这种关联在未经产的妇女中[RR 8.0（95%CI：2.9，21.6）]比在先前活产的妇女中[RR 1.8（95%CI：0.7，4.5）]强得多。所有围产期死亡都发生在没有在蚊帐下睡觉的妇女中。生活在城市贫民窟的妇女比生活在农村地区的妇女失去婴儿的风险更高[RR：2.7（95%CI：1.4，5.3）]。结论：我们的研究结果加强了确保孕妇获得和使用足够的分娩设施和蚊帐的论点。
Background: To achieve a child mortality reduction according to millennium development goal 4, it is necessary to considerably reduce neonatal mortality. We report stillbirth and early neonatal mortality risks as well as determinants of perinatal mortality in Eastern Uganda.Methods: A community-based prospective cohort study was conducted between 2006 and 2008. A total of 835 pregnant women were followed up for pregnancy outcome and survival of their children until 7 days after delivery. Mother's residence, age, parity, bed net use and whether delivery took place at home were included in multivariable regression analyses to identify risk factors for perinatal death.Results: The stillbirth risk was 19 per 1,000 pregnancies and the early neonatal death risk 22 per 1,000 live births. Overall, the perinatal mortality risk was 41 [95%CI: 27, 54] per 1,000 pregnancies. Of the deaths, 47% followed complicated deliveries and 24% preterm births. Perinatal mortality was 63/1,000 pregnancies among teenage mothers, 76/1,000 pregnancies among nulliparous women and 61/1,000 pregnancies among women delivering at home who, after controlling for potential confounders, had a 3.7 (95%CI: 1.8, 7.4) times higher perinatal mortality than women who gave birth in a health facility. This association was considerably stronger among nulliparous women [RR 8.0 (95%CI: 2.9, 21.6)] than among women with a previous live birth [RR 1.8 (95%CI: 0.7, 4.5)]. All perinatal deaths occurred among women who did not sleep under a mosquito net. Women living in urban slums had a higher risk of losing their babies than those in rural areas [RR: 2.7 (95%CI: 1.4, 5.3)].Conclusion: Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.