肯尼亚纳罗克县一个牧民社区的孕妇在产前护理中使用定向手机干预的产后新生儿结局:随机对照试验

D. Muvengei, Simon Karanja, P. Wanzala
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摘要

背景:在全球范围内,尤其是在中低收入国家,妊娠、分娩和产褥期并发症导致妇女和新生儿的死亡率和发病率居高不下。产前保健是改善孕产妇和儿童健康的一项关键性、高影响力战略。本研究的目的是考察在提供产前护理时使用有针对性的手机干预措施对牧民社区孕妇的就诊率和后续产后结果的影响。研究方法我们在肯尼亚纳罗克县的四家医院开展了一项随机对照试验(RCT)。在怀孕初期招募孕妇,并随访至产后 42 天。招募工作于 2018 年 6 月开始。研究分为两组:干预组和非干预组,非干预组接受常规护理。研究结果280 名研究参与者中有 262 人完成了研究(回复率为 93.6%)。干预组(6.06%)和非干预组(15.38%)的新生儿出生时死亡比例相差 9.32%(95% CI 1.91-16.74%)(P 值 = 0.015)。结论在产前护理中使用有针对性的手机干预措施与提高产前护理就诊率和改善新生儿预后有关。关键词产后新生儿预后;有针对性的手机干预;在孕妇产前护理中使用;肯尼亚纳罗克县的一个牧民社区。
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Postnatal neonatal outcomes of a targeted mobile phone intervention use in antenatal care amongst pregnant women in a pastoralist community in narok county, Kenya: a randomized control trial
Background: Complications in pregnancy, at childbirth and the pueperium cause high mortality and morbidity among women and neonates globally especially in the Lower and Middle Income Countries. Antenatal care is a key high impact strategy to improve maternal and child health. The objective of the study was to examine the effects of a targeted mobile phone intervention use in the provision of antenatal care on attendance and subsequent postnatal outcomes among pregnant women in a pastoralist community. Methods: We conducted a Randomized Controlled Trial (RCT) in four hospitals in Narok County, Kenya. Pregnant women were recruited early in pregnancy and followed upto 42 days after delivery. Recruitment started in June 2018. There were two study groups; the intervention and non-intervention groups with the non-intervention group receiving the routine care. Results: Two-hundred-and-sixty-two of the 280 study participants completed the study (93.6% response rate). The difference in proportion of study participants who had neonatal mortality at birth between the two study arms was 9.32% (95% CI 1.91-16.74%) between the intervention (6.06%) and the non-intervention (15.38%) study arms (p value = 0.015). Conclusion: A targeted mobile phone intervention used in antenatal care was associated with improved antenatal care attendance and better neonatal outcomes. Keywords: Postnatal neonatal outcomes; targeted mobile phone intervention; use in antenatal care amongst pregnant women; in a pastoralist community in Narok county; Kenya.
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