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
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-
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