目的:描述发病率,以及与尼日利亚早产和围产期死亡率相关的社会人口统计学和临床因素。
方法:对通过孕产妇围产期质量数据库收集的数据进行二次分析,公平与尊严(MPD-4-QED)计划。
方法:来自尼日利亚54家转诊级医院2019年9月1日至2020年8月31日的出生数据。
方法:共有69698例分娩。
方法:多水平模型用于确定与早产和围产期死亡率相关的因素。
方法:早产和早产围产期死亡率。
结果:在62383名活产儿中,9547为早产(每1000名活产153名)。产妇年龄(<20岁-调整后比值比[aOR]1.52,95%CI1.36-1.71;>35岁-aOR1.23,95%CI1.16-1.30),没有正规教育(aOR1.68,95%CI1.54-1.84),非有偿工作的伴侣(aOR1.94,95%CI1.61-2.34)和无产前护理(aOR2.62,95%CI2.42-2.84)与早产相关.早产儿的早期新生儿死亡率为47.2/1000早产儿(451/9547)。父亲的职业(体力劳动aOR1.52,95%CI1.20-1.93),妊娠期高血压疾病(aOR1.37,95%CI1.02-1.83),没有产前护理(aOR2.74,95%CI2.04-3.67),妊娠早期(28~<32周-aOR2.94,95%CI2.15~4.10;32~<34周-aOR1.80,95%CI1.3~2.44)和出生体重<1000g(aOR21.35,95%CI12.54~36.33)与围产期死亡率相关.
结论:尼日利亚的早产和围产期死亡率很高。应努力增加怀孕期间获得优质保健的机会,分娩和新生儿期,提高父母的社会经济地位。
OBJECTIVE: To describe the incidence, and sociodemographic and clinical factors associated with preterm birth and perinatal mortality in Nigeria.
METHODS: Secondary analysis of data collected through the Maternal Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) Programme.
METHODS: Data from births in 54 referral-level hospitals across Nigeria between 1 September 2019 and 31 August 2020.
METHODS: A total of 69 698 births.
METHODS: Multilevel modelling was used to determine the factors associated with preterm birth and perinatal mortality.
METHODS: Preterm birth and preterm perinatal mortality.
RESULTS: Of 62 383 live births, 9547 were preterm (153 per 1000 live births). Maternal age (<20 years - adjusted odds ratio [aOR] 1.52, 95% CI 1.36-1.71; >35 years - aOR 1.23, 95% CI 1.16-1.30), no formal education (aOR 1.68, 95% CI 1.54-1.84), partner not gainfully employed (aOR 1.94, 95% CI 1.61-2.34) and no antenatal care (aOR 2.62, 95% CI 2.42-2.84) were associated with preterm births. Early neonatal mortality for preterm neonates was 47.2 per 1000 preterm live births (451/9547). Father\'s occupation (manual labour aOR 1.52, 95% CI 1.20-1.93), hypertensive disorders of pregnancy (aOR 1.37, 95% CI 1.02-1.83), no antenatal care (aOR 2.74, 95% CI 2.04-3.67), earlier gestation (28 to <32 weeks - aOR 2.94, 95% CI 2.15-4.10; 32 to <34 weeks - aOR 1.80, 95% CI 1.3-2.44) and birthweight <1000 g (aOR 21.35, 95% CI 12.54-36.33) were associated with preterm perinatal mortality.
CONCLUSIONS: Preterm birth and perinatal mortality in Nigeria are high. Efforts should be made to enhance access to quality health care during pregnancy, delivery and the neonatal period, and improve the parental socio-economic status.