■降低新生儿死亡率是一个全球目标,但是在大多数资源受限的环境中很少研究其因素。这是第一项研究,以确定影响圣多美和普林西比(STP)围产期和新生儿死亡的因素,中部非洲最小的国家。
■在医院AyresMenezes博士进行的基于机构的前瞻性队列研究。在第28天的生命(n=194)后对纳入的母婴二联组进行随访,以鉴定新生儿死亡结局(n=22)和存活结局组(n=172)。数据是从怀孕卡中收集的,医院记录和面对面访谈。出生后的第28天,打了一个电话来评估新生儿的健康状况。获得粗比值比和相应的95%置信区间。P值<0.05被认为是统计学上显著的。
■死亡结局组和存活结局组的平均孕龄分别为36周(SD=4.8)和39周(SD=1.4),分别。死亡结局组(n=22)包括16例死胎,四个早期和两个晚期新生儿死亡。高危妊娠评分[cOR2.91,95%CI:1.18-7.22],胎粪污染液[cOR4.38,95%CI:1.74-10.98],胎膜长期破裂[cOR4.84,95%CI:1.47-15.93],从另一个单位转移[cOR6.08,95%CI:1.95-18.90],和工具性阴道分娩[cOR8.90,95%CI:1.68-47.21],是与死亡显著相关的因素。有感染风险的新生儿死亡的几率更高,IUGR,复苏演习,出生时胎儿窘迫,出生窒息,和单位护理入院。发现女性新生儿[cOR0.37,95%CI:0.14-1.00]和出生体重超过2,500g[cOR0.017,95%CI:0.002-0.162]是保护因素。
■高危妊娠评分等因素,羊水胎粪污染,长时间的胎膜破裂,从另一个单位转移过来,工具辅助阴道分娩使死产和新生儿死亡的风险增加了4至9倍.因此,避免延误及时的产时护理是圣多美和普林西比实施的一项关键战略。
UNASSIGNED: Neonatal mortality reduction is a global goal, but its factors are seldom studied in most resource-constrained settings. This is the first
study conducted to identify the factors affecting perinatal and neonatal deaths in Sao Tome & Principe (STP), the smallest Central Africa country.
UNASSIGNED: Institution-based prospective cohort
study conducted at Hospital Dr. Ayres Menezes. Maternal-neonate dyads enrolled were followed up after the 28th day of life (n = 194) for identification of neonatal death-outcome (n = 22) and alive-outcome groups (n = 172). Data were collected from pregnancy cards, hospital records and face-to-face interviews. After the 28th day of birth, a phone call was made to evaluate the newborn\'s health status. Crude odds ratios and corresponding 95% confidence intervals were obtained. A p value <0.05 was considered statistically significant.
UNASSIGNED: The mean gestational age of the death-outcome and alive-outcome groups was 36 (SD = 4.8) and 39 (SD = 1.4) weeks, respectively. Death-outcome group (n = 22) included sixteen stillbirths, four early and two late neonatal deaths. High-risk pregnancy score [cOR 2.91, 95% CI: 1.18-7.22], meconium-stained fluid [cOR 4.38, 95% CI: 1.74-10.98], prolonged rupture of membranes [cOR 4.84, 95% CI: 1.47-15.93], transfer from another unit [cOR 6.08, 95% CI:1.95-18.90], and instrumental vaginal delivery [cOR 8.90, 95% CI: 1.68-47.21], were factors significantly associated with deaths. The odds of experiencing death were higher for newborns with infectious risk, IUGR, resuscitation maneuvers, fetal distress at birth, birth asphyxia, and unit care admission. Female newborn [cOR 0.37, 95% CI: 0.14-1.00] and birth weight of more than 2,500 g [cOR 0.017, 95% CI: 0.002-0.162] were found to be protective factors.
UNASSIGNED: Factors such as having a high-risk pregnancy score, meconium-stained amniotic fluid, prolonged rupture of membranes, being transferred from another unit, and an instrumental-assisted vaginal delivery increased 4- to 9-fold the risk of stillbirth and neonatal deaths. Thus, avoiding delays in prompt intrapartum care is a key strategy to implement in Sao Tome & Principe.