背景:死胎是全球常见的不良妊娠结局,估计每年有260万例死胎。在喀麦隆,2015年的报告比率为19.6/1000活产.已经描述了几个风险因素,但喀麦隆西北部地区的特定地区风险因素尚不清楚。这项研究旨在确定巴门达地区医院的死胎率和相关因素,喀麦隆西北地区。
方法:于2022年12月至2023年6月在巴门达地区医院进行了一项基于医院的病例对照研究,内容涉及2018年至2022年的医疗档案。病例为胎龄≥28周的死产妇女,而对照组是以1:2(1例2对照)比例匹配的活产妇女,使用母亲年龄。社会人口统计学,产科,medical,和新生儿因素被用作暴露变量。使用多变量逻辑回归确定暴露变量的校正比值比,其置信区间为95%,p值<0.05。
结果:共有12,980例分娩,包括116例死胎,死胎率为8.9/1000活产。包括100个病例和200个对照。多变量分析后与死胎相关的因素包括无效(aOR=3.89;95%CI:1.19-12.71;p=0.025),未参加产前护理(aOR=104;95%CI:3.17-3472;p=0.009),死产史(aOR=44;95%CI:7-270;p<0.0001),胎盘早剥(aOR=14;95%CI:2.4-84;p=0.003),妊娠期高血压疾病(aOR=18;95%CI:3.4-98;p=0.001),疟疾(aOR=8;95%CI:1.51-42;p=0.015),饮酒(aOR=9;95%CI:1.72-50;p=0.01),出生体重小于2500g(aOR=16;95%CI:3.0-89;p=0.001),和先天性畸形(aOR=12.6;95%CI:1.06-149.7;p=0.045)。
结论:BRH的死胎率为8.9/1000活产。死产的相关因素包括无效胎,没有参加产前护理,死胎史,胎盘早剥,妊娠期高血压疾病,疟疾,酒精消费,出生体重低于2500克,先天性畸形.建议对具有此类相关因素的妇女进行密切的产前护理随访。
BACKGROUND: Stillbirth is a common adverse pregnancy outcome worldwide, with an estimated 2.6 million stillbirths yearly. In Cameroon, the reported rate in 2015 was 19.6 per 1000 live births. Several risk factors have been described, but region-specific risk factors are not known in the northwest region of Cameroon. This study aims to determine the stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region of Cameroon.
METHODS: A Hospital-based
case‒control study conducted from December 2022 to June 2023 on medical files from 2018 to 2022 at the Bamenda Regional Hospital. Cases were women with stillbirths that occurred at a gestational age of ≥ 28 weeks, while controls were women with livebirths matched in a 1:2 (1
case for 2 controls) ratio using maternal age. Sociodemographic, obstetric, medical, and neonatal factors were used as exposure variables. Multivariable logistic regression was used to determine adjusted odds ratios of exposure variables with 95% confidence intervals and a p value of < 0.05.
RESULTS: A total of 12,980 births including 116 stillbirths giving a stillbirth rate of 8.9 per 1000 live births. A hundred cases and 200 controls were included. Factors associated with stillbirths after multivariable analysis include nulliparity (aOR = 3.89; 95% CI: 1.19-12.71; p = 0.025), not attending antenatal care (aOR = 104; 95% CI: 3.17-3472; p = 0.009), history of stillbirth (aOR = 44; 95% CI: 7-270; p < 0.0001),
placenta abruption (aOR = 14; 95% CI: 2.4-84; p = 0.003), hypertensive disorder in pregnancy (aOR = 18; 95% CI: 3.4-98; p = 0.001), malaria (aOR = 8; 95% CI: 1.51-42; p = 0.015), alcohol consumption (aOR = 9; 95% CI: 1.72-50; p = 0.01), birth weight less than 2500 g (aOR = 16; 95% CI: 3.0-89; p = 0.001), and congenital malformations (aOR = 12.6; 95% CI: 1.06-149.7;p = 0.045).
CONCLUSIONS: The stillbirth rate in BRH is 8.9 per 1000 live births. Associated factors for stillbirth include nulliparity, not attending antenatal care, history of stillbirth, placental abruption, hypertensive disorder in pregnancy, malaria, alcohol consumption, birth weight less than 2500 g, and congenital malformations. Close antenatal care follow-up of women with such associated factors is recommended.