Facteurs associés à la morbi-mortalité maternelle et périnatale chez les accouchées d’au moins 35 ans aux Cliniques Universitaires de Lubumbashi de 2021 à 2022
Mots-clés :
Childbirth, elderly woman, frequency, morbidity and mortality, University Clinics of Lubumbashi, Accouchement, femme âgée, fréquence, morbi-mortalité, Cliniques Universitaires de LubumbashiRésumé
Introduction
L’étude avait pour objectifs de déterminer la fréquence des accouchements chez les gestantes âgées d’au moins 35 ans ; décrire leurs caractéristiques sociodémographiques ; identifier et évaluer le risque de morbi-mortalité maternelle et périnatale chez ces femmes comparativement aux femmes âgées de 20 à 34 ans.
Matériels et Méthodes : Une étude descriptive et analytique cas – témoins était réalisée aux Cliniques Universitaires de Lubumbashi du 01 Janvier 2021 au 30 Juin 2022 avec un échantillon exhaustif et de commodité incluant 215 cas contre 215 témoins. Les tests de Chi-carré et t de Student ont été utilisés pour comparer respectivement les proportions et les moyennes, la régression logistique pour l’analyse multivariée ainsi que l’OR et son IC à 95 % pour évaluer le niveau d’association entre variables. Le seuil de signification a été fixé à p < 0,05.
Résultats : La fréquence des accouchements des gestantes âgées de 35 ans et plus était de 7,46%. Les gestantes âgées de 35 ans et plus étaient multipares et grandes multipares (p<0,0001). La morbidité maternelle chez les cas était caractérisée par un risque significativement plus élevé d’hématome rétro placentaire (ORa=7,9 [1,7–36,7]), d’utilisation d’ocytocine (ORa=3,4 [2,1–5,3]) et d’induction du travail (ORa=3,6 [1,8 – 7,3]). Le décès périnatal (ORa=5,1 [1,1–22,8]) était significativement plus associé à l’âge maternel ≥35 ans.
Conclusion : L’accouchement de la femme âgée est assez fréquent à Lubumbashi, et présente un risque important de morbi-mortalité maternelle et périnatale, méritant de ce fait une attention et une prise en charge appropriées.
ABSTRACT
Introduction: The objectives of our study were to: determine the frequency of childbirth among pregnant women aged 35 and over; describe the socio-demographic characteristics of the mothers concerned; and identify the risk factors associated with maternal and perinatal morbidity and mortality compared to women aged 20 to 34 years.
Materials and methods: A descriptive case-control study was carried out at the University Clinics of Lubumbashi from January 01, 2021 to June 30, 2022 with an exhaustive study sample of convenience systematically including 215 cases against 215 controls. The following statistical tests and estimates were used: Chi-square and Student's t tests to compare the proportions and means respectively, logistic regression for the multivariate analysis as well as the OR and its 95% CI to evaluate the level of association between variables. The significance level was set at p < 0.05.
Results: The childbirths frequency of pregnant women aged 35 and over was 7.46%. Pregnant women aged 35 and over were multiparous and grand multiparous (p<0.0001). Maternal morbidity and mortality in the study group, compared to pregnant women aged 20 to 34, was characterized by a significantly higher risk of retroplacental hematoma (aOR=7.9 [1.7–36.7]), use of oxytocin (aOR=3.4 [2.1–5.3]) and induction of labor (aOR=3.6 [1.8–7.3]). Regarding perinatal morbidity and mortality, perinatal death (aOR=5.1 [1.1–22.8]) was significantly more associated with maternal age ≥35 years.
Conclusion: The childbirth of the elderly woman is quite frequent in Lubumbashi, presents a significant risk of maternal and perinatal morbidity and mortality, thus deserving of attention and appropriate care.
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Références
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