Mercedes Colomar, Bremen de Mucio, Claudio Sosa, Rodolfo Gomez, Luis Mainero, Renato T Souza, Maria L Costa, Adriana G Luz, Maria H Sousa, Carmen M Cruz, Luz M Chevez, Rita Lopez, Gema Carrillo, Ulises Rizo, Erika E Saint Hillaire, William E Arriaga, Rosa M Guadalupe, Carlos Ochoa, Freddy Gonzalez, Rigoberto Castro, Allan Stefan, Amanda Moreno, Suzanne J Serruya, José G Cecatti
{"title":"不同产妇发病程度的新生儿结局：来自CLAP网络围产期信息系统（SIP）的横断面证据。","authors":"Mercedes Colomar, Bremen de Mucio, Claudio Sosa, Rodolfo Gomez, Luis Mainero, Renato T Souza, Maria L Costa, Adriana G Luz, Maria H Sousa, Carmen M Cruz, Luz M Chevez, Rita Lopez, Gema Carrillo, Ulises Rizo, Erika E Saint Hillaire, William E Arriaga, Rosa M Guadalupe, Carlos Ochoa, Freddy Gonzalez, Rigoberto Castro, Allan Stefan, Amanda Moreno, Suzanne J Serruya, José G Cecatti","doi":"10.1080/16549716.2023.2269736","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging.</p><p><strong>Objectives: </strong>To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities.</p><p><strong>Methods: </strong>This is a secondary cross-sectional analysis of the Perinatal Information System (SIP) database from eight health facilities in five Latin American and Caribbean countries. Participants were all women delivering from August 2018 to June 2021, excluding cases of abortion, multiple pregnancies and missing information on perinatal outcomes. As primary and secondary outcome measures, neonatal near miss and neonatal death were measured according to maternal/pregnancy characteristics and degrees of maternal morbidity. Estimated adjusted prevalence ratios (PRadj) with their respective 95% CIs were reported.</p><p><strong>Results: </strong>In total 85,863 live births were included, with 1,250 neonatal near miss (NNM) cases and 695 identified neonatal deaths. NNM and neonatal mortality ratios were 14.6 and 8.1 per 1,000 live births, respectively. Conditions independently associated with a NNM or neonatal death were the need for neonatal resuscitation (PR<sub>adj</sub> 16.73, 95% CI [13.29-21.05]), being single (PR<sub>adj</sub> 1.45, 95% CI [1.32-1.59]), maternal near miss or death (PR<sub>adj</sub> 1.64, 95% CI [1.14-2.37]), preeclampsia (PR<sub>adj</sub> 3.02, 95% CI [1.70-5.35]), eclampsia/HELPP (PR<sub>adj</sub> 1.50, 95% CI [1.16-1.94]), maternal age (years) (PR<sub>adj</sub> 1.01, 95% CI [<1.01-1.02]), major congenital anomalies (PR<sub>adj</sub> 3.21, 95% CI [1.43-7.23]), diabetes (PR<sub>adj</sub> 1.49, 95% CI [1.11-1.98]) and cardiac disease (PR<sub>adj</sub> 1.65, 95% CI [1.14-2.37]).</p><p><strong>Conclusion: </strong>Maternal morbidity leads to worse neonatal outcomes, especially in women suffering maternal near miss or death. Based on SIP/PAHO database all these indicators may be helpful for routine situation monitoring in Latin America with the purpose of policy changes and improvement of maternal and neonatal health.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neonatal outcomes according to different degrees of maternal morbidity: cross-sectional evidence from the Perinatal Information System (SIP) of the CLAP network.\",\"authors\":\"Mercedes Colomar, Bremen de Mucio, Claudio Sosa, Rodolfo Gomez, Luis Mainero, Renato T Souza, Maria L Costa, Adriana G Luz, Maria H Sousa, Carmen M Cruz, Luz M Chevez, Rita Lopez, Gema Carrillo, Ulises Rizo, Erika E Saint Hillaire, William E Arriaga, Rosa M Guadalupe, Carlos Ochoa, Freddy Gonzalez, Rigoberto Castro, Allan Stefan, Amanda Moreno, Suzanne J Serruya, José G Cecatti\",\"doi\":\"10.1080/16549716.2023.2269736\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging.</p><p><strong>Objectives: </strong>To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities.</p><p><strong>Methods: </strong>This is a secondary cross-sectional analysis of the Perinatal Information System (SIP) database from eight health facilities in five Latin American and Caribbean countries. Participants were all women delivering from August 2018 to June 2021, excluding cases of abortion, multiple pregnancies and missing information on perinatal outcomes. As primary and secondary outcome measures, neonatal near miss and neonatal death were measured according to maternal/pregnancy characteristics and degrees of maternal morbidity. Estimated adjusted prevalence ratios (PRadj) with their respective 95% CIs were reported.</p><p><strong>Results: </strong>In total 85,863 live births were included, with 1,250 neonatal near miss (NNM) cases and 695 identified neonatal deaths. NNM and neonatal mortality ratios were 14.6 and 8.1 per 1,000 live births, respectively. Conditions independently associated with a NNM or neonatal death were the need for neonatal resuscitation (PR<sub>adj</sub> 16.73, 95% CI [13.29-21.05]), being single (PR<sub>adj</sub> 1.45, 95% CI [1.32-1.59]), maternal near miss or death (PR<sub>adj</sub> 1.64, 95% CI [1.14-2.37]), preeclampsia (PR<sub>adj</sub> 3.02, 95% CI [1.70-5.35]), eclampsia/HELPP (PR<sub>adj</sub> 1.50, 95% CI [1.16-1.94]), maternal age (years) (PR<sub>adj</sub> 1.01, 95% CI [<1.01-1.02]), major congenital anomalies (PR<sub>adj</sub> 3.21, 95% CI [1.43-7.23]), diabetes (PR<sub>adj</sub> 1.49, 95% CI [1.11-1.98]) and cardiac disease (PR<sub>adj</sub> 1.65, 95% CI [1.14-2.37]).</p><p><strong>Conclusion: </strong>Maternal morbidity leads to worse neonatal outcomes, especially in women suffering maternal near miss or death. Based on SIP/PAHO database all these indicators may be helpful for routine situation monitoring in Latin America with the purpose of policy changes and improvement of maternal and neonatal health.</p>\",\"PeriodicalId\":49197,\"journal\":{\"name\":\"Global Health Action\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2023-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Health Action\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/16549716.2023.2269736\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Health Action","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16549716.2023.2269736","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/27 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Neonatal outcomes according to different degrees of maternal morbidity: cross-sectional evidence from the Perinatal Information System (SIP) of the CLAP network.
Background: The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging.
Objectives: To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities.
Methods: This is a secondary cross-sectional analysis of the Perinatal Information System (SIP) database from eight health facilities in five Latin American and Caribbean countries. Participants were all women delivering from August 2018 to June 2021, excluding cases of abortion, multiple pregnancies and missing information on perinatal outcomes. As primary and secondary outcome measures, neonatal near miss and neonatal death were measured according to maternal/pregnancy characteristics and degrees of maternal morbidity. Estimated adjusted prevalence ratios (PRadj) with their respective 95% CIs were reported.
Results: In total 85,863 live births were included, with 1,250 neonatal near miss (NNM) cases and 695 identified neonatal deaths. NNM and neonatal mortality ratios were 14.6 and 8.1 per 1,000 live births, respectively. Conditions independently associated with a NNM or neonatal death were the need for neonatal resuscitation (PRadj 16.73, 95% CI [13.29-21.05]), being single (PRadj 1.45, 95% CI [1.32-1.59]), maternal near miss or death (PRadj 1.64, 95% CI [1.14-2.37]), preeclampsia (PRadj 3.02, 95% CI [1.70-5.35]), eclampsia/HELPP (PRadj 1.50, 95% CI [1.16-1.94]), maternal age (years) (PRadj 1.01, 95% CI [<1.01-1.02]), major congenital anomalies (PRadj 3.21, 95% CI [1.43-7.23]), diabetes (PRadj 1.49, 95% CI [1.11-1.98]) and cardiac disease (PRadj 1.65, 95% CI [1.14-2.37]).
Conclusion: Maternal morbidity leads to worse neonatal outcomes, especially in women suffering maternal near miss or death. Based on SIP/PAHO database all these indicators may be helpful for routine situation monitoring in Latin America with the purpose of policy changes and improvement of maternal and neonatal health.
期刊介绍：
Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research.
Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health.
Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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