背景:慢性病的发病率,是孕产妇死亡和新生儿不良结局的重要原因,加纳北部育龄妇女的比例正在上升。这个新出现的健康问题引起了人们对这种情况下不良分娩结局的潜在恶化的严重关切。鉴于它是该国此类结果发生率高的地区之一。我们调查了早产(PTB)的风险,低出生体重(LBW),在加纳北部的塔马利大都市,在受孕前患有慢性疾病的妇女中并发PTB和LBW。
方法:对从5个公共卫生机构中随机选择的420名产后妇女进行了一项基于机构的横断面研究。以电子方式收集有关参与者自我报告的慢性病经历的信息,即,高血压,糖尿病,哮喘,心脏病,镰状细胞病,在他们最近怀孕之前。还收集了有关分娩时胎龄和出生体重的信息。回归模型用于量化妊娠前已存在慢性疾病的妇女中不良新生儿结局的风险。
结果:慢性疾病影响了我们样本的31.2%。其中,28.6%有单一慢性疾病,2.6%患有慢性疾病。PTB的患病率为24.0%(95%CI:20.2,28.4),27.6%(95%CI:23.5,32.1)的新生儿出生LBW,17.4%(95%CI:14.0,21.3)的妊娠导致PTB和LBW。与没有慢性病的人相比,受孕前患有慢性病的女性患PTB的风险更大(aOR=6.78,95%CI:3.36,13.68),LBW(AOR=5.75,95%CI:2.96,11.18),PTB和LBW同时出现(aOR=7.55,95%CI:3.32,17.18)。
结论:我们观察到PTB的显着发生率,LBW,以及PTB和LBW在受孕前已经意识到自己已经存在慢性病的女性中同时发生。我们的发现强调了在分娩前提供给这些妇女的产前护理质量方面的潜在差距。孕前保健可能提供一个机会,以解决妇女在怀孕前预先存在的慢性病,并有可能改善孕产妇和新生儿的健康结果。
BACKGROUND: The incidence of chronic diseases, which are significant contributors to maternal deaths and adverse new-born outcomes, is increasing among women of reproductive age in northern Ghana. This emerging health issue raises serious concerns about the potential exacerbation of adverse birth outcomes in this setting, given that it is one of the regions in the country with a high incidence of such outcomes. We investigated the risks of preterm birth (PTB), low birth weight (LBW), and concurrent PTB and LBW among women with preexisting chronic conditions prior to conception in the Tamale Metropolis of northern Ghana.
METHODS: A facility-based cross-sectional study was conducted among 420 postpartum women randomly selected from five public health facilities. Information was collected electronically on participants\' self-reported experience of chronic conditions, namely, hypertension, diabetes, asthma, heart disease, and sickle cell disease, prior to their most recent pregnancy. Information on gestational age at delivery and birth weight was also collected. Regression modeling was used to quantify the risk of adverse newborn outcomes among women who reported preexisting chronic conditions prior to pregnancy.
RESULTS: Chronic diseases affected 31.2% of our sample. Of these, 28.6% had a single chronic condition, while 2.6% had comorbid chronic conditions. The prevalence of PTB was 24.0% (95% CI: 20.2, 28.4), 27.6% (95% CI: 23.5, 32.1) of the newborns were born LBW, and 17.4% (95% CI: 14.0, 21.3) of the pregnancies resulted in both PTB and LBW. Compared with those without chronic conditions, women with chronic conditions prior to conception had a greater risk of PTB (aOR = 6.78, 95% CI: 3.36, 13.68), LBW (aOR = 5.75, 95% CI: 2.96, 11.18), and the co-occurrence of PTB and LBW (aOR = 7.55, 95% CI: 3.32, 17.18).
CONCLUSIONS: We observed significant rates of PTB, LBW, and the co-occurrence of PTB and LBW among women who were already aware that they had preexisting chronic conditions prior to conception. Our findings highlight a potential gap in the quality of prenatal care provided to these women before delivery. Preconception care may offer an opportunity to address preexisting chronic conditions in women before pregnancy and potentially improve maternal and newborn health outcomes.