International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2013
Injections during labor and intrapartum-related hypoxic injury and mortality in rural southern Nepal.
СтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mullany Luke C, Khatry Subarna K, Katz Joanne, Stanton Cynthia K, Lee Anne C C, Darmstadt Gary L, LeClerq Steven C, Tielsch James M
Аннотация
OBJECTIVE: To estimate the association between unmonitored use of injections during labor and intrapartum-related neonatal mortality and morbidity among home births.
METHODS: Recently delivered women in Sarlahi, Nepal, reported whether they had received injections during labor. Data on breathing and crying status at birth, time to first breath, respiratory rate, sucking ability, and lethargy were gathered. Neonatal respiratory depression (NRD) and encephalopathy (NE) were compared by injection receipt status using multivariate regression models.
RESULTS: Injections during labor were frequently reported (7108 of 22352 [31.8%]) and were predominantly given by unqualified village "doctors." Multivariate analysis (excluding facility births and complicated deliveries) revealed associations with intrapartum-related NRD (relative risk [RR] 2.52; 95% CI, 2.29-2.78) and NE (RR 3.48; 95% CI, 2.46-4.93). The risks of neonatal death associated with intrapartum-related NRD (RR 3.78; 95% CI, 2.53-5.66) or NE (RR 4.47; 95% CI, 2.78-7.19) were also elevated.
CONCLUSION: Injection during labor was widespread at the community level. This practice was associated with poor outcomes and possibly related to the inappropriate use of uterotonics by unqualified providers. Interventions are required to increase the safety of childbirth in the community and in peripheral health facilities. Parent trial registered at clinicaltrials.gov (NCT00 109616).
METHODS: Recently delivered women in Sarlahi, Nepal, reported whether they had received injections during labor. Data on breathing and crying status at birth, time to first breath, respiratory rate, sucking ability, and lethargy were gathered. Neonatal respiratory depression (NRD) and encephalopathy (NE) were compared by injection receipt status using multivariate regression models.
RESULTS: Injections during labor were frequently reported (7108 of 22352 [31.8%]) and were predominantly given by unqualified village "doctors." Multivariate analysis (excluding facility births and complicated deliveries) revealed associations with intrapartum-related NRD (relative risk [RR] 2.52; 95% CI, 2.29-2.78) and NE (RR 3.48; 95% CI, 2.46-4.93). The risks of neonatal death associated with intrapartum-related NRD (RR 3.78; 95% CI, 2.53-5.66) or NE (RR 4.47; 95% CI, 2.78-7.19) were also elevated.
CONCLUSION: Injection during labor was widespread at the community level. This practice was associated with poor outcomes and possibly related to the inappropriate use of uterotonics by unqualified providers. Interventions are required to increase the safety of childbirth in the community and in peripheral health facilities. Parent trial registered at clinicaltrials.gov (NCT00 109616).