بررسی عوامل خطر مرتبط با مرده‌زایی در مادران باردار: مطالعه مورد- شاهدی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد اپیدمیولوژی، شبکه بهداشت و درمان قائن، دانشگاه علوم پزشکی بیرجند، بیرجند، ایران.

2 کارشناس ارشد اپیدمیولوژی، شبکه بهداشت و درمان کمیجان، دانشگاه علوم پزشکی اراک، اراک، ایران.

3 کارشناس بهداشت عمومی، شبکه بهداشت و درمان قائن، دانشگاه علوم پزشکی بیرجند، بیرجند، ایران.

4 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

چکیده

مقدمه: مرده ­زایی، یکی از پیامدهای نامطلوب تولد هم در کشورهای در حال توسعه و هم در کشورهای توسعه یافته است. در سراسر جهان بیش از میلیون­ ها بارداری با مرده ­زایی به پایان می­ رسد که بیشتر آن­ها در کشورهای با درآمد متوسط و پایین رخ می دهد. مطالعه حاضر با هدف تعیین عوامل خطرزای مادری و جنینی برای تولد نوزاد مرده در شهرستان قائنات انجام شد.
روش‌کار: این مطالعه مورد - شاهدی از سال 1400-1395 بر روی 104 مورد مرده­ زایی و 208 تولد زنده (شاهد) در سطح مراکز بهداشتی شهری و روستایی شهرستان قائنات انجام شد. داده­ های مرتبط با مرده ­زایی با استفاده از چک‌لیست محقق ساخته جمع ­آوری شد. تجزیه و تحلیل داده ها با استفاده از نرم‌افزار آماری SPSS (نسخه 26) و آزمون­ های کای اسکوئر و لوجستیک انجام شد. میزان p کمتر از 05/0 معنی ­دار در نظر گرفته شد.
یافته­ ها: میزان کل مرده ­زایی 88/9 در 1000 تولد زنده بود. در تحلیل تک‌متغیره بین سن مادر (04/0=p)، سن همسر (009/0=p)، سابقه تولد دوقلویی (006/0=p)، سابقه وجود بیماری زمینه ­ای (04/0=p)، سن بارداری (001/0=p)، وزن تولد (001/0=p)، سابقه وجود سقط (02/0=p) و مرده ­زایی (03/0=p) با سابقه مرده ­زایی رابطه معنی­ داری وجود داشت. در تحلیل رگرسیون لوجستیک چندمتغیره، تولد نوزاد زیر 37 هفته با (77/17=aOR، 83/20-43/7=CI، 001/0>p)، وزن زمان تولد کمتر از 2500 گرم (36/5=aOR، 96/22-12/2=CI، 001/0>p) و سابقه سقط (38/2=aOR، 27/5- 07/1=CI 03/0=p) رابطه معنی­ داری با مرده­ زایی نشان دادند.
نتیجه­ گیری: شیوع مرده ­زایی در شهرستان قائنات نسبتاً بالا بود. در این مطالعه عوامل خطر متعدد مادری و جنینی همچون تولد کمتر از 37 هفته سن بارداری، وزن تولد کمتر از 2500 گرم و سابقه سقط برای مرده­ زایی شناسایی شدند. شناسایی زودهنگام حاملگی­ های در معرض خطر و مداخله مناسب ممکن است به کاهش وقوع مرده ­زایی کمک کند، بنابراین می­ توان افراد پرخطر را شناسایی و زمینه آموزش و مشاوره­ های لازم را برای آنها فراهم نمود.

کلیدواژه‌ها

عنوان مقاله [English]

Risk factors related to stillbirth in pregnant mothers: a case-control study

نویسندگان [English]

  • Zohre Gozidehkar 1
  • Ali Asghar Ghalenoei 2
  • Fateme Ghotbi 3
  • Shahrbanoo Ashkriz 3
  • Hourie Karbalaei Taher 4
1 M.Sc. of Epidemiology, Qaen Treatment and Health Network, Birjand University of Medical Sciences, Birjand, Iran.
2 M.Sc. of Epidemiology, Komijan Treatment and Health Network, Arak University of Medical Sciences, Arak, Iran.
3 B.Sc. of Public Health, Qaen Treatment and Health Network, Birjand University of Medical Sciences, Birjand, Iran.
4 General practitioner, Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
چکیده [English]

Introduction: Stillbirth is one of the adverse outcomes of birth in both developing and developed countries. Worldwide, more than a million pregnancies end in stillbirth, most of which occur in low- and middle-income countries. This study was conducted with aim to determine maternal and fetal risk factors for stillbirth in Qaenat city.
Methods: This case-control study was conducted from 2016-2021 on 104 stillbirths and 208 live births (controls) in urban and rural health centers of Qaenat city. Data related to stillbirths were collected using a researcher-made checklist. Data analysis was done using SPSS software (version 26) and chi-square and logistic tests. P< 0.05 was considered statistically significant.
Results: The total stillbirth rate was 9.88 per 1000 live births. In univariate analysis, mother's age (P=0.04), husband's age (P=0.009), history of twin birth (P=0.006), history of underlying disease (P=0.04), gestational age (P=0.001), birth weight (P=0.001), history of abortion (P=0.02) and history of stillbirth (P=0.03) showed a significant relationship with stillbirth. In the multivariate logistic regression analysis, the birth of a baby under 37 weeks (aOR=17.77, CI:7.20-43.83, P<0.001), birth weight less than 2500 gr (aOR=5.36, CI:2.22-12.96, P<0.001) and history of abortion (aOR=2.38, CI:1.07-5.27, P=0.03) showed a significant relationship with stillbirth.
Conclusion: The prevalence of stillbirth in Qaenat city was relatively high. In this study, several maternal and fetal risk factors such as birth less than 37 weeks gestational age, birth weight less than 2500 gr and history of abortion were identified for stillbirth. Early identification of at-risk pregnancies and appropriate intervention may help reduce the occurrence of stillbirths. Therefore, it is necessary to identify high-risk people and provide them with necessary training and counseling.

کلیدواژه‌ها [English]

  • Case-control
  • Pregnancy
  • Qaenat
  • Risk factors
  • Stillbirth

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 2
اردیبهشت 1402
صفحه 74-83

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