The effect of prenatal and intrapartum care on the stillbirth rate among women in rural Ethiopia
The effect of prenatal and intrapartum care on the stillbirth rate among women in rural Ethiopia
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DOI：
10.1016/j.ijgo.2015.09.027
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发表时间：
2016-05-01
影响因子：
3.8
通讯作者：
Atnafu, Habtamu
中科院分区：
文献类型：
--
作者：
Ballard, Karen;Belete, Zelalem;Atnafu, Habtamu
目的：确定以社区为基础的产前和产时护理是否能降低死产率。方法：在2014年5月至12月期间，在埃塞俄比亚北部和东部随机选择一组在过去12个月内分娩过一名新生儿的妇女，对她们每次分娩的孕产妇服务体验和胎儿结局进行面对面调查。比较了在家分娩和在保健机构分娩的妇女的死胎率。结果：总共有4442名女性完成了调查。2437名接受产前护理的妇女中有42名（1.7%）报告了死产，1921名未接受产前护理的妇女中有53名（2.8%）报告了死产（P = 0.01）。在保健中心（27/1417[1.9%]）、在医院（6/126[4.8%]）和在家（62/2725 [2.3%];P = 0.13）分娩的妇女的死产率相似。然而，遇到产时紧急情况的妇女在卫生机构分娩的可能性是其两倍（优势比2.6,95%可信区间2.2-3.0）。对保健中心服务的满意度为中等好（中位得分77.5/100）。结论：接受产前护理的妇女的死产率降低了，尽管在卫生机构分娩并没有降低死产的风险。提高保健中心的护理质量可以使它们有计划地用于分娩，这可能会降低死产率。(C) 2016年国际妇产科联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: To determine whether community-based prenatal and intrapartum care in Ethiopia results in a lower stillbirth rate. Methods: Between May and December 2014, a randomly selected sample of women in northern and eastern Ethiopia who had delivered a neonate in the preceding 12 months completed a face-to-face survey about their experiences of maternal services and the fetal outcome for each delivery. The stillbirth rates among women delivering at home and at health facilities were compared. Results: Overall, 4442 women completed surveys. Stillbirth was reported by 42 (1.7%) of the 2437 women who had received prenatal care and 53 (2.8%) of the 1921 women who did not receive prenatal care (P = 0.01). The stillbirth rate was similar among women who delivered in a health center (27/1417 [1.9%]), in a hospital (6/126 [4.8%]), and at home (62/2725 [2.3%]; P = 0.13). However, women experiencing an intrapartum emergency were twice as likely to deliver in a health facility (odds ratio 2.6, 95% confidence interval 2.2-3.0). Satisfaction with health-center care was moderately good (median score 77.5/100). Conclusion: The stillbirth rate was reduced among women receiving prenatal care, although delivering in a health facility did not reduce the risk of stillbirth. Improving the quality of health-center care could lead to their planned use for childbirth, which might reduce stillbirth rates. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.