估计产妇入院时的死亡风险:乌干达北部五年病例参考研究的预测模型。

IF 12.5 1区 医学 Q1 ONCOLOGY
Cancer research Pub Date : 2022-03-17 eCollection Date: 2022-01-01 DOI:10.1155/2022/4419722
Gasthony Alobo, Cristina Reverzani, Laura Sarno, Barbara Giordani, Luigi Greco
{"title":"估计产妇入院时的死亡风险:乌干达北部五年病例参考研究的预测模型。","authors":"Gasthony Alobo, Cristina Reverzani, Laura Sarno, Barbara Giordani, Luigi Greco","doi":"10.1155/2022/4419722","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda.</p><p><strong>Methods: </strong>This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019. Multivariate logistic regression was used to estimate the net effect of the associated factors. A cumulative risk score for each woman based on the unstandardised canonical coefficients was obtained by the discriminant equation.</p><p><strong>Results: </strong>The average maternal mortality ratio was 328 per 100,000 live births. Direct obstetric causes contributed to 73.8% of maternal deaths; the most common were haemorrhage (42.7%), sepsis (24.0%), hypertensive disorders (18.7%) and complications of abortion (2.1%), whereas malaria (23.5%) and HIV/AIDS (20.6%) were the leading indirect causes. The odds of dying were higher among women who were aged 30 years or more (OR 1.12; 95% CI, 1.04-1.19), did not attend antenatal care (OR 3.11; 95% CI, 1.36-7.09), were HIV positive (OR 3.13; 95% CI, 1.41-6.95), had a caesarean delivery (OR 2.22; 95% CI 1.13-4.37), and were referred from other facilities (OR 5.57; 95% CI 2.83-10.99).</p><p><strong>Conclusion: </strong>Mortality is high among mothers referred late from other facilities who are HIV positive, aged more than 30 years, lack antenatal care attendance, and are delivered by caesarean section. This calls for prompt and better assessment of referred mothers and specific attention to antibiotic therapy before and after caesarean section, especially among HIV-positive women.</p>","PeriodicalId":9441,"journal":{"name":"Cancer research","volume":"72 1","pages":"4419722"},"PeriodicalIF":12.5000,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947917/pdf/","citationCount":"0","resultStr":"{\"title\":\"Estimating the Risk of Maternal Death at Admission: A Predictive Model from a 5-Year Case Reference Study in Northern Uganda.\",\"authors\":\"Gasthony Alobo, Cristina Reverzani, Laura Sarno, Barbara Giordani, Luigi Greco\",\"doi\":\"10.1155/2022/4419722\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda.</p><p><strong>Methods: </strong>This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019. Multivariate logistic regression was used to estimate the net effect of the associated factors. A cumulative risk score for each woman based on the unstandardised canonical coefficients was obtained by the discriminant equation.</p><p><strong>Results: </strong>The average maternal mortality ratio was 328 per 100,000 live births. Direct obstetric causes contributed to 73.8% of maternal deaths; the most common were haemorrhage (42.7%), sepsis (24.0%), hypertensive disorders (18.7%) and complications of abortion (2.1%), whereas malaria (23.5%) and HIV/AIDS (20.6%) were the leading indirect causes. The odds of dying were higher among women who were aged 30 years or more (OR 1.12; 95% CI, 1.04-1.19), did not attend antenatal care (OR 3.11; 95% CI, 1.36-7.09), were HIV positive (OR 3.13; 95% CI, 1.41-6.95), had a caesarean delivery (OR 2.22; 95% CI 1.13-4.37), and were referred from other facilities (OR 5.57; 95% CI 2.83-10.99).</p><p><strong>Conclusion: </strong>Mortality is high among mothers referred late from other facilities who are HIV positive, aged more than 30 years, lack antenatal care attendance, and are delivered by caesarean section. This calls for prompt and better assessment of referred mothers and specific attention to antibiotic therapy before and after caesarean section, especially among HIV-positive women.</p>\",\"PeriodicalId\":9441,\"journal\":{\"name\":\"Cancer research\",\"volume\":\"72 1\",\"pages\":\"4419722\"},\"PeriodicalIF\":12.5000,\"publicationDate\":\"2022-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947917/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/4419722\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2022/4419722","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:乌干达是撒哈拉以南非洲孕产妇死亡率非常高的国家之一,估计每 10 万名活产婴儿中有 336 名产妇死亡。我们的目的是探索影响产妇死亡的主要因素,并设计一个预测模型,用于估计乌干达北部一家主要转诊医院的产妇入院时死亡的风险:这是一项回顾性匹配病例对照研究,于2015年1月至2019年12月在乌干达北部的拉科尔医院进行,包括130例病例和336例对照。采用多变量逻辑回归估算相关因素的净效应。通过判别方程得出了基于非标准化卡农系数的每位妇女的累积风险评分:产妇平均死亡率为每 10 万活产 328 例。产科直接原因占产妇死亡的 73.8%;最常见的原因是大出血(42.7%)、败血症(24.0%)、高血压疾病(18.7%)和流产并发症(2.1%),而疟疾(23.5%)和艾滋病毒/艾滋病(20.6%)则是主要的间接原因。年龄在 30 岁或以上(OR 1.12;95% CI,1.04-1.19)、未参加产前护理(OR 3.11;95% CI,1.36-7.09)、HIV 阳性(OR 3.13;95% CI,1.41-6.95)、剖腹产(OR 2.22;95% CI,1.13-4.37)和从其他机构转诊(OR 5.57;95% CI,2.83-10.99)的产妇死亡几率更高:结论:从其他医疗机构转诊的艾滋病病毒呈阳性、年龄超过 30 岁、缺乏产前护理和剖腹产的产妇死亡率很高。这就要求对转诊产妇进行及时和更好的评估,并在剖腹产前后特别注意抗生素治疗,尤其是艾滋病毒呈阳性的产妇。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estimating the Risk of Maternal Death at Admission: A Predictive Model from a 5-Year Case Reference Study in Northern Uganda.

Background: Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda.

Methods: This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019. Multivariate logistic regression was used to estimate the net effect of the associated factors. A cumulative risk score for each woman based on the unstandardised canonical coefficients was obtained by the discriminant equation.

Results: The average maternal mortality ratio was 328 per 100,000 live births. Direct obstetric causes contributed to 73.8% of maternal deaths; the most common were haemorrhage (42.7%), sepsis (24.0%), hypertensive disorders (18.7%) and complications of abortion (2.1%), whereas malaria (23.5%) and HIV/AIDS (20.6%) were the leading indirect causes. The odds of dying were higher among women who were aged 30 years or more (OR 1.12; 95% CI, 1.04-1.19), did not attend antenatal care (OR 3.11; 95% CI, 1.36-7.09), were HIV positive (OR 3.13; 95% CI, 1.41-6.95), had a caesarean delivery (OR 2.22; 95% CI 1.13-4.37), and were referred from other facilities (OR 5.57; 95% CI 2.83-10.99).

Conclusion: Mortality is high among mothers referred late from other facilities who are HIV positive, aged more than 30 years, lack antenatal care attendance, and are delivered by caesarean section. This calls for prompt and better assessment of referred mothers and specific attention to antibiotic therapy before and after caesarean section, especially among HIV-positive women.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Cancer research
Cancer research 医学-肿瘤学
CiteScore
16.10
自引率
0.90%
发文量
7677
审稿时长
2.5 months
期刊介绍: Cancer Research, published by the American Association for Cancer Research (AACR), is a journal that focuses on impactful original studies, reviews, and opinion pieces relevant to the broad cancer research community. Manuscripts that present conceptual or technological advances leading to insights into cancer biology are particularly sought after. The journal also places emphasis on convergence science, which involves bridging multiple distinct areas of cancer research. With primary subsections including Cancer Biology, Cancer Immunology, Cancer Metabolism and Molecular Mechanisms, Translational Cancer Biology, Cancer Landscapes, and Convergence Science, Cancer Research has a comprehensive scope. It is published twice a month and has one volume per year, with a print ISSN of 0008-5472 and an online ISSN of 1538-7445. Cancer Research is abstracted and/or indexed in various databases and platforms, including BIOSIS Previews (R) Database, MEDLINE, Current Contents/Life Sciences, Current Contents/Clinical Medicine, Science Citation Index, Scopus, and Web of Science.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信