背景:关于怀孕期间咀嚼khat对胎儿和妊娠的影响知之甚少。本研究的目的是确定怀孕期间咀嚼khat对埃塞俄比亚部分妊娠结局的影响,2022年:采用广义结构方程建模分析方法的队列研究。
方法:在埃塞俄比亚东部的选定医院进行了一项基于机构的前瞻性队列研究。包括在满足资格标准的研究期间访问研究区域中的选定医院的孕妇,直到满足样本量(344)。本研究中研究的主要结局是早产和低出生体重。通过人体测量和临床测量收集数据,面试官进行问卷调查。进行生存分析和广义线性模型分析以估计粗略和调整后的相对风险和归因风险。使用数据科学统计软件(Stata)“GSEM”命令进行广义结构方程建模(GSEM)分析,以检查调解效果。
结果:出现早产的风险明显高于阿拉伯茶咀嚼者[调整后相对危险度(aRR)=2.19;95CI1.21-3.96]。在调整妊娠高血压和剖宫产后的进一步分析中,怀孕期间咀嚼卡塔对早产的回归系数从路径n减小,β=0.37,p<0.001到路径n\',β=0.15,p<0.005。Khat咀嚼者发生低出生体重的风险明显更高(aRR=4.17;95CI2.11-8.25)。在调整妊娠高血压后的进一步分析中,剖宫产,早产和母体贫血,怀孕期间咀嚼卡塔对低出生体重的回归系数从路径q减小,β=0.4,p<0.001到路径q',β=0.2,p<0.001。
结论:总体而言,目前的研究表明,咀嚼khat不仅是当前人口的担忧,也是影响未出生胎儿的一代的公共卫生问题。
BACKGROUND: Little is known about the fetal and pregnancy effects of khat chewing during pregnancy. The aim of the current study was to determine the impact of chewing khat during pregnancy on selected pregnancy outcomes in Ethiopia, 2022: A Cohort Study with a Generalized Structural Equation Modeling Analysis Approach.
METHODS: An institution-based prospective cohort study was employed in selected hospitals in eastern Ethiopia. Pregnant women who visited the selected hospitals in the study area during the study period that fulfilled the eligibility criteria were included until a sample size (344) was fulfilled. The main outcomes studied in the present study were preterm birth and low birth weight. Data were collected through anthropometric and clinical measurements, and interviewers administered questionnaires. The survival analysis and generalized linear model analysis were performed to estimate the crude and adjusted relative risk and attributable risk. The Generalized Structural Equation Modeling (GSEM) analysis was performed using the Statistical software for data science (Stata) \'GSEM\' command to examine the mediation effect.
RESULTS: The risk of occurrence of preterm birth was significantly higher among khat chewers [adjusted relative risk (aRR) = 2.19; 95%CI 1.21-3.96]. In further analysis after adjusting for gestational hypertension and cesarean delivery, the regression coefficient of khat chewing during pregnancy on preterm birth has been decreased in size from path n, β = 0.37, p<0.001 to path n\', β = 0.15, p<0.005. The risk of occurrence of low birth weight among khat chewers was significantly higher (aRR = 4.17; 95%CI 2.11-8.25). In further analysis after adjusting for gestational hypertension, cesarean delivery, preterm birth and maternal anemia, the regression coefficient of khat chewing during pregnancy on low birth weight has been decreased in size from path q, β = 0.4, p<0.001 to path q\', β = 0.2, p<0.001.
CONCLUSIONS: Overall, the present study revealed that khat chewing is not only a worry of the current population but also a public health concern of the generation affecting unborn fetuses.