Transfer of newborns to neonatal care unit a registry based study in Northern Tanzania 英文参考文献.docVIP

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Transfer of newborns to neonatal care unit a registry based study in Northern Tanzania 英文参考文献.doc

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Transfer of newborns to neonatal care unit a registry based study in Northern Tanzania 英文参考文献

Mmbagaetal.BMCPregnancyandChildbirth2011,11:68 /1471-2393/11/68 RESEARCH ARTICLE OpenAccess Transferofnewbornstoneonatalcareunit: aregistrybasedstudyinNorthernTanzania BlandinaTMmbaga1,2,3*,RolvTLie2,4,GibsonSKibiki1,5,RaimosOlomi1,GunnarKv?le 3andAnneKDaltveit2,4 Abstract Background:Reductioninneonatalmortalityhasbeenslowerthananticipatedinmanylowincomecountries includingTanzania.Adequateneonatalcaremaycontributetoreducedmortality.Westudiedfactorsassociated withtransferofbabiestoaneonatalcareunit(NCU)indatafromabirthregistryatKilimanjaroChristianMedical Centre(KCMC)inTanzania. Methods:Atotalof21206singletonlivebirthsregisteredfrom2000to2008wereincluded.Multivariableanalysis wascarriedouttostudyneonataltransfertoNCUbysocio-demographicfactors,pregnancycomplicationsand measuresoftheconditionofthenewborn. Results:Atotalof3190(15%)newbornsingletonsweretransferredtotheNCU.Asexpected,neonataltransferwas stronglyassociatedwithspecificconditionsofthebabyincludingbirthweightabove4000g(relativerisk(RR)= 7.2;95%confidenceinterval(CI)6.5-8.0)orbelow1500g(RR=3.0;95%CI:2.3-4.0),fiveminutesApgarscoreless than7(RR=4.0;95%CI:3.4-4.6),andpretermbirthbefore34weeksofgestation(RR=1.8;95%CI:1.5-2.1). However,pregnancy-anddelivery-relatedconditionslikeprematureruptureofmembrane(RR=2.3;95%CI:1.9- 2.7),preeclampsia(RR=1.3;95%CI:1.1-1.5),othervaginaldelivery(RR=2.2;95%CI:1.7-2.9)andcaesareansection (RR=1.9;95%CI:1.8-2.1)werealsosignificantlyassociatedwithtransfer.Birthtoafirstbornchildwasassociated withincreasedlikelihoodoftransfer(relativerisk(RR)1.4;95%CI:1.2-1.5),whilethelikelihoodwasreduced(RR= 0.5;95%CI:0.3-0.9)whenthefatherhadnoeducation. Conclusions:Inadditiontostrongassociationsbetweenneonataltransferandclassicalneonatalriskfactorsfor morbidityandmortality,somepregnancy-relatedanddemographicfactorswerepredictorsofneonataltransfer. Overall,transferwasmorelikelyforbabieswithsignsofpoorhealthstatusoracomplicatedpregnancy.Exceptfor apossiblyreduceduseoftransferforbabiesofnon-