Incidence, risk factors and consequences of preterm birth - findings from a multi-centric observational study for 14 months in Nepal
Incidence, risk factors and consequences of preterm birth - findings from a multi-centric observational study for 14 months in Nepal
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DOI：
10.1186/s13690-020-00446-7
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发表时间：
2020-07-17
影响因子：
3.3
通讯作者：
Ashish, K. C.
中科院分区：
文献类型：
--
作者：
Gurung, Abhishek;Wrammert, Johan;Ashish, K. C.
背景早产是一种世界性的流行病，也是新生儿死亡的主要原因。在这项研究中，我们旨在评估尼泊尔早产的发生率、危险因素和后果。所有在研究期间出生的婴儿都包括在研究中。妊娠37周出生的婴儿被归类为早产。对早产的相关因素和结局进行单因素和多元回归分析。20岁以下的母亲(AOR 1.26；1.15-1.39)早产的风险很高。同样，母亲的教育程度是早产的重要预测因素：文盲母亲(1.41；1.22-1.64)、识字母亲(1.21；1.08-1.35)和受过基本教育的母亲(1.17；1.07-1.27)。社会人口因素，如吸烟(AOR 1.13；1.01-1.26)、使用污染燃料(AOR 1.26；1.17-1.35)和婴儿性别(AOR 1.18；1.11-1.26)；产科因素，如未生育(AOR 1.33；1.20-1.48)、多胎(AOR 6.63；5.16-8.52)、孕期严重贫血(AOR 3.27；2.21-4.84)、中期孕期产前检查(AOR 1.13；孕晚期(AOR 1.24；1.12-1.38)、孕期探视4次(AOR 1.49；1.38-1.61)是早产的重要危险因素。早产具有出院前死亡的风险(10.60；9.28-12.10)。结论本研究发现早产的发生率较高。各种社会人口、产科和新生儿危险因素与早产有关。修改风险因素和及时干预将有助于减少早产和相关死亡率。
Background Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal.Methods This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born < 37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted.Results The incidence of preterm was found to be 93 per 1000 live births. Mothers aged less than 20 years (aOR 1.26;1.15-1.39) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.41; 1.22-1.64), literate mothers (aOR 1.21; 1.08-1.35) and mothers having basic level of education (aOR 1.17; 1.07-1.27). Socio-demographic factors such as smoking (aOR 1.13; 1.01-1.26), use of polluted fuel (aOR 1.26; 1.17-1.35) and sex of baby (aOR 1.18; 1.11-1.26); obstetric factors such as nulliparity (aOR 1.33; 1.20-1.48), multiple delivery (aOR 6.63; 5.16-8.52), severe anemia during pregnancy (aOR 3.27; 2.21-4.84), antenatal visit during second trimester (aOR 1.13; 1.05-1.22) and third trimester (aOR 1.24; 1.12-1.38), < 4 antenatal visits during pregnancy (aOR 1.49; 1.38-1.61) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10).Conclusion In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities.