刚果民主共和国卢本巴希新生儿败血症的危险因素:一项回顾性病例对照研究

Nyenga Am, O. Mukuku, Sun Jz, Assumani An, O. Luboya, W. So
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摘要

目的:新生儿败血症(NS)是新生儿发病率和死亡率的主要原因,尤其是在发展中国家。NS的识别和治疗延误是造成高死亡率的主要原因。本研究旨在确定刚果民主共和国卢本巴希两所大学医院新生儿NS的风险因素。方法:采用系统抽样方法,于2019年11月至2020年10月对486对母婴进行了基于医院的病例对照研究。使用STATA软件(版本15)对数据进行分析。计算二元和多变量逻辑回归分析,以确定95%置信区间的相关因素。结果:本研究共纳入162例病例和324名对照。多元逻辑回归分析显示,本研究中NS的可能危险因素为低教育水平(AOR=9.16[2.23-7.67])、母体泌尿生殖道感染(AOR=42.59[17.90-101.37])、胎膜早破(AOR=19.95[7.27-54.76])、围产期发热(AOR=26.25[2.31-297.83])、分娩时间过长(AOR=14.16[3.88-51.71]),剖宫产(AOR=3.57[1.48-8.61])、阴道分娩受阻(AOR=13.40[1.32-136.19])、出生体重<1500克(AOR=70.38[8.64-572.95])和1500-2500克(AOR=7.90[3.04-2.522])。本研究提示了对具有上述特征的新生儿进行败血症常规评估的可能性。
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Risk factors for neonatal sepsis in Lubumbashi, Democratic Republic of Congo: A retrospective case-control study
Purpose: Neonatal sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR = 9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR = 42.59 [17.90-101.37]), premature rupture of membranes (AOR = 19.95 [7.27-54.76]), peripartum fever (AOR = 26.25 [2.31-297.83]), prolonged labor (AOR = 14.16 [3.88-51.71]), cesarean section (AOR = 3.57 [1.48-8.61]), obstructed vaginal delivery (AOR = 13.40 [1.32-136.19]), birth weight <1500 grams (AOR = 70.38 [8.64-572.95]), and between 1500-2500 grams (AOR = 7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.
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