斯里兰卡早产的危险因素:病例对照研究

D. Peiris, K. Jayaratne, R. Seneviratne
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引用次数: 0

摘要

前言:早产是低收入和中等收入国家(LMIC)新生儿和儿童死亡率的一个主要因素。许多国家努力预防和照顾早产儿。关于早产危险因素的具体国家可靠数据对于制定预防战略至关重要。目的:确定斯里兰卡早产的产前危险因素方法:在斯里兰卡科伦坡区设有产科和新生儿护理设施的七家政府医院进行了一项无与伦比的病例对照研究。活产的,自发的或提供者发起的,374名早产儿(妊娠24周)作为病例,374名活产的足月婴儿作为对照,这些婴儿来自22周前进行约会扫描的母亲。通过广泛的文献检索和专家咨询得出的风险因素概况进行多变量分析以确定风险因素。结果:确定的危险因素有:多胎妊娠(调整优势比(aOR)=10.57;95% ci: 3.48, 32.08);妊娠期出血/点滴出血(aOR=3.51;95% CI: 1.77, 6.98),既往早产(aOR= 2.83;95% CI: 1.09, 7.36),近期有压力的生活事件(aOR=2.62;95% CI: 1.43, 4.81),较高的重力(aOR=2.58;95% CI: 1.35, 4.9),对自我评估的健康不满意(aOR=2.54;95% CI: 1.52, 4.22),妊娠高血压(aOR=2.25;95% CI: 1.16, 4.38),无产前牙科评估(aOR=2.16;95% CI: 1.23, 3.81),口腔卫生不理想(aOR=2.01;95% CI: 1.33, 3.04),妊娠晚期站立时间长(aOR=1.91;95% CI: 1.24, 2.94)和使用柴火做饭(aOR=1.51;95% ci: 1.01, 2.25)。性节制(aOR=0.46;95% CI: 0.26, 0.81)为保护因素。结论与建议:确定了可改变和不可改变的早产因素。对于多胎妊娠、妊娠期间有点滴出血和曾经早产的孕妇,建议在妊娠期间进行特别护理并尽早入院。建议在怀孕期间避免压力,注意口腔卫生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors of preterm birth in Sri Lanka: case-control study
Introduction: Preterm birth is a major challenge as a contributor to neonatal and child mortality in low- and middle-income countries (LMIC). Many countries toil to prevent and care for preterm babies. Country-specific solid data on risk factors of preterm births are crucial to formulate preventive strategies. Objectives: To determine the antenatal risk factors of preterm births in Sri Lanka Methods: An unmatched case-control study was conducted in seven Government hospitals with obstetric and neonatal care facilities in Colombo District in Sri Lanka. Live-born, spontaneous or provider-initiated, 374 preterm babies (<37 & >24 weeks of gestation) as cases and live-born 374 term babies as controls were recruited from mothers who had a dating scan before 22 weeks. A risk factor profile worked out by extensive literature search and consultation of experts was subjected to multivariable analysis to identify risk factors. Results: Risk factors identified were: multiple pregnancy (adjusted odds ratio (aOR)=10.57; 95% CI: 3.48, 32.08); bleeding/spotting during pregnancy (aOR=3.51; 95% CI: 1.77, 6.98), past preterm birth (aOR= 2.83; 95% CI: 1.09, 7.36), recent stressful life event (aOR=2.62; 95% CI: 1.43, 4.81), higher gravidity (aOR=2.58; 95% CI: 1.35, 4.9), dissatisfaction with self-assessed own health (aOR=2.54; 95% CI: 1.52, 4.22), pregnancy induced hypertension (aOR=2.25; 95% CI: 1.16, 4.38), no antenatal dental assessment (aOR=2.16; 95% CI: 1.23, 3.81), unsatisfactory oral hygiene (aOR=2.01; 95% CI: 1.33, 3.04), long standing hours during 3rd trimester (aOR=1.91; 95% CI: 1.24, 2.94) and cooking using firewood (aOR=1.51; 95% CI: 1.01, 2.25). Sexual abstinence (aOR=0.46; 95% CI: 0.26, 0.81) was a protective factor. Conclusions & Recommendations: Modifiable and unmodifiable factors for preterm births were identified. Special care during pregnancy and early admission is recommended for multiple pregnancy, those had spotting during pregnancy and those had past preterm delivery. Avoiding stress during pregnancy and emphasizing oral hygiene are recommended.
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