1
|
Díaz-Rodríguez A, Feliz-Matos L, Ruiz Matuk CB. Risk factors associated with preterm birth in the Dominican Republic: a case-control study. BMJ Open 2021; 11:e045399. [PMID: 34933854 PMCID: PMC8693088 DOI: 10.1136/bmjopen-2020-045399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/28/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic. DESIGN Case-control study. SETTINGS Seven National Reference Hospitals from different regions of the Dominican Republic. PARTICIPANTS A probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1 =0.5, P2 =0.6, and β=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports. PRIMARY OUTCOME MEASURES A protocol was created to obtain maternal and obstetric information. RESULTS The main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=-10.294, p<0.001). CONCLUSION Maternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.
Collapse
|
2
|
Alamneh TS, Teshale AB, Worku MG, Tessema ZT, Yeshaw Y, Tesema GA, Liyew AM, Alem AZ. Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries. BMC Pregnancy Childbirth 2021; 21:770. [PMID: 34781891 PMCID: PMC8591945 DOI: 10.1186/s12884-021-04233-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. METHODS The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. RESULTS In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. CONCLUSION The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth.
Collapse
Affiliation(s)
- Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
3
|
Zini ME, Omo-Aghoja LO. Clinical and sociodemographic correlates of preterm deliveries in two tertiary hospitals in southern Nigeria. Ghana Med J 2019; 53:20-28. [PMID: 31138940 PMCID: PMC6527821 DOI: 10.4314/gmj.v53i1.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background To determine the prevalence of preterm delivery and identify the associated risk factors. Design This was a five - month prospective case control study of two cohorts of women who had preterm and term deliveries. Setting Central Hospital (CH), Warri, and Delta State University Teaching Hospital (DELSUTH), Oghara, respectively in southern Nigeria. Participants 522 women which consisted of 174 who presented in preterm labour or with preterm prelabour rupture of membranes as cases and 348 parturient with term deliveries served as controls. Interventions The study was conducted from May 1st 2015 to September 30th 2015. Socio - demographic characteristics, past gynaecological/obstetric factors, maternal/obstetric factors, and fetal outcomes were compared, and associations between these variables and gestational age at delivery were determined. Main outcome measures Prevalence of preterm delivery associated clinical and socio-demographic correlates and the fetal salvage rates. Results The incidence of preterm birth was 16%. Maternal age (p < 0.002), parity (p < 0.000), booking status (p < 0.000), and socio - economic class (p < 0.000) were significantly associated with preterm births. Others were multiple pregnancy (p < 0.000), pre - eclampsia/eclampsia (p < 0.000), anaemia (p < 0.000), malaria (p < 0.000), UTI (p < 0.012), premature rupture of membrane (p < 0.000) and antepartum haemorrhage (p < 0.000). Fetal salvage rate was zero for extreme preterm neonates and 100% at late preterm. Conclusion Preterm birth was common, with well-defined correlates and predictors. The fetal salvage rates were significantly different across the categories of preterm neonates. Funding The study was self-funded by the authors
Collapse
Affiliation(s)
- Mudiaga E Zini
- Department of Obstetrics and Gynaecology, Epsom General Hospital, Epsom, Surrey, United Kingdom
| | - Lawrence O Omo-Aghoja
- Department of Obstetrics and Gynecology, Faculty of Clinical Medicine, College of Health Sciences, Delta State University, Abraka, Nigeria
| |
Collapse
|
4
|
Bener A, Al-Nufal M, Vachhani PJ, Ali AI, Samson N, Saleh NM. Maternal complications and neonatal outcome in Arab women of a fast developing country. J Family Community Med 2013; 20:27-34. [PMID: 23723728 PMCID: PMC3663161 DOI: 10.4103/2230-8229.108181] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The objective of the study was to examine maternal complications that occur during the third trimester and their neonatal outcome in Arab women residing in Qatar. DESIGN This is a prospective hospital-based study. SETTING The survey was carried out in women's hospital. MATERIALS AND METHODS The study was based on the log book of the women's hospital, from which we recruited women in their third trimester of pregnancy between the first week of January 2010 and April 2011. Of the 1 824 Arab women who were approached to participate in the study, 1 432 (78.5%) consented. Face-to-face interviews were conducted with the pregnant women in the third trimester attending routine antenatal clinics at a women's hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Medical records of the patients were referred to collect the clinical variables. RESULTS Of the pregnant women studied, 39.8% were less than 30 years of age. The risk of maternal complications was higher in housewives (60.8%) and women with a low monthly household income (38.2%). Most of the pregnant women (77.6%) had antenatal care. Normal delivery (69.7%) was more common in expatriate Arab women, whereas caesarean was more prevalent in Qatari women (22.2%). Women aged 35 years or older had a significantly higher risk of maternal complications such as gestational diabetes (20.8% vs 13.4%; P < 0.01), gestational hypertension (21.6% vs 15.2%; P = 0.003), and ante-partum hemorrhage (17.9% vs 13.7%; P = 0.042) than younger women. Gestational diabetes increased the risk of caesarean delivery (25.1%) and macrosomia (42.3%). The frequency of caesarean delivery (22.1%) was higher in women with gestational hypertension. Neonatal complications such as Apgar score (<7) 1 minute (33.1% vs 21.2%; P < 0.001), 5 minutes (13.1% vs 8.2%; P = 0.005), and congenital anomalies (2.9% vs 0.9%; P = 0.007) were significantly higher in newborns of older women. Low birth weight (11.1%) and Apgar 1(st) minute < 7 rate (28.2%) were higher in newborns of mothers with ante-partum hemorrhage. CONCLUSION The study findings revealed that maternal complications such as gestational diabetes, gestational hypertension, ante-partum hemorrhage, and maternal anemia were significantly higher in older pregnant women. Similarly, neonatal complications were higher in the newborns of older women. Gestational hypertension was the leading maternal complication observed in Arab women.
Collapse
Affiliation(s)
- Abdulbari Bener
- Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Qatar
- Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK
- Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar
| | - Mohammed Al-Nufal
- Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar
| | - Pankit J. Vachhani
- Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar
| | - Awab I. Ali
- Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar
| | - Nancy Samson
- Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Qatar
| | - Najah M. Saleh
- Department of Obstetrics and Gynecology, Women's Hospital, Hamad Medical Corporation, Qatar
| |
Collapse
|
5
|
Ezechi OC, David AN, Gab-Okafor CV, Ohwodo H, Oladele DA, Kalejaiye OO, Ezeobi PM, Gbajabiamila TA, Adu RA, Oke B, Musa ZA, Ekama SO, Ilesanmi O, Odubela O, Somefun EO, Herbertson EC, Onwujekwe DI, Ujah IAO. Incidence of and socio-biologic risk factors for spontaneous preterm birth in HIV positive Nigerian women. BMC Pregnancy Childbirth 2012; 12:93. [PMID: 22958756 PMCID: PMC3449176 DOI: 10.1186/1471-2393-12-93] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 08/31/2012] [Indexed: 11/10/2022] Open
Abstract
Background Recent studies have identified HIV as a leading contributor to preterm delivery and its associated morbidity and mortality. However little or no information exists in our sub-region on this subject. Identifying the factors associated with preterm delivery in HIV positive women in our country and sub-region will not only prevent mother to child transmission of HIV virus but will also reduce the morbidity and mortality associated with prematurity and low birth weight. This study was designed to determine the incidence and risk factors for preterm delivery in HIV positive Nigerians. Method The required data for this retrospective study was extracted from the data base of a cohort study of the outcome of prevention of mother to child transmission at the Nigerian Institute of Medical Research, Lagos. Only data of women that met the eligibility of spontaneous delivery after 20 weeks of gestation were included. Ethical approval was obtained from the Institution’s Ethical Review Board. Results 181 women out of the 1626 eligible for inclusion into the study had spontaneous preterm delivery (11.1%). The mean birth weight was 3.1 ± 0.4 kg, with 10.3% having LBW. Spontaneous preterm delivery was found to be significantly associated with unmarried status (cOR: 1.7;1.52-2.57), baseline CD4 count <200 cells/mm3(cOR: 1.8; 1.16-2.99), presence of opportunistic infection at delivery (cOR: 2.2;1.23-3.57), multiple pregnancy (cOR 10.4; 4.24 – 26.17), use of PI based triple ARV therapy (eOR 10.2; 5.52 – 18.8) in the first trimester (cOR 2.5; 1.77 – 3.52) on univariate analysis. However after multivariate analysis controlling for potential confounding variables including low birth weight, only multiple pregnancy (aOR: 8.6; CI: 6.73 – 12.9), presence of opportunistic infection at delivery (aOR: 1.9; CI: 1.1 – 5.7), and 1st trimester exposure to PI based triple therapy (aOR: 5.4; CI: 3.4 – 7.8) retained their significant association with preterm delivery. Conclusion The spontaneous preterm delivery rate among our cohort was 11.1%. HIV positive women with multiple pregnancies, symptomatic HIV infection at delivery and first trimester fetal exposure to PI based triple therapy were found to be at risk of spontaneous preterm delivery. Early booking and non-use of PI based triple therapy in the first trimester will significantly reduce the risk of preterm delivery.
Collapse
Affiliation(s)
- Oliver C Ezechi
- HIV Treatment Centre, Clinical Sciences Division, Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos, Nigeria.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Al-Dabbagh SA, Al-Taee WY. Risk factors for pre-term birth in Iraq: a case-control study. BMC Pregnancy Childbirth 2006; 6:13. [PMID: 16618372 PMCID: PMC1479367 DOI: 10.1186/1471-2393-6-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2005] [Accepted: 04/18/2006] [Indexed: 11/10/2022] Open
Abstract
Background Preterm birth (PTB)is a major clinical problem associated with perinatal mortality and morbidity. The aim of the present study is to identify risk factors associated with PTB in Mosul, Iraq. Methods A case-control study was conducted in Mosul, Iraq, from 1st September, 2003 to 28th February, 2004. Results A total of 200 cases of PTB and 200 controls of full-term births were screened and enrolled in the study. Forward logistic regression analysis was used in the analysis. Several significant risk associations between PTB and the following risk factors were identified: poor diet (OR = 4.33), heavy manual work (OR = 1.70), caring for domestic animals (OR = 5.06), urinary tract infection (OR = 2.85), anxiety (OR = 2.16), cervical incompetence (OR = 4.74), multiple pregnancies (OR = 7.51), direct trauma to abdomen (OR = 3.76) and abortion (OR = 6.36). Conclusion The main determinants of PTB in Iraq were low socio-economic status and factors associated with it, such as heavy manual work and caring for domestic animals, in addition to urinary tract infections and poor obstetric history.
Collapse
Affiliation(s)
- Samim A Al-Dabbagh
- Department of Community Medicine, Mosul College of Medicine, Mosul, Iraq
| | | |
Collapse
|
7
|
Nepomnaschy PA, Welch KB, McConnell DS, Low BS, Strassmann BI, England BG. Cortisol levels and very early pregnancy loss in humans. Proc Natl Acad Sci U S A 2006; 103:3938-42. [PMID: 16495411 PMCID: PMC1533790 DOI: 10.1073/pnas.0511183103] [Citation(s) in RCA: 188] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Maternal stress is commonly cited as an important risk factor for spontaneous abortion. For humans, however, there is little physiological evidence linking miscarriage to stress. This lack of evidence may be attributable to a paucity of research on maternal stress during the earliest gestational stages. Most human studies have focused on "clinical" pregnancy (>6 weeks after the last menstrual period). The majority of miscarriages, however, occur earlier, within the first 3 weeks after conception (approximately 5 weeks after the last menstrual period). Studies focused on clinical pregnancy thus miss the most critical period for pregnancy continuance. We examined the association between miscarriage and levels of maternal urinary cortisol during the first 3 weeks after conception. Pregnancies characterized by increased maternal cortisol during this period (within participant analyses) were more likely to result in spontaneous abortion (P < 0.05). This evidence links increased levels in this stress marker with a higher risk of early pregnancy loss in humans.
Collapse
Affiliation(s)
- Pablo A Nepomnaschy
- Department of Anthropology, 1085 South University Avenue, University of Michigan, Ann Arbor, MI 48109, USA.
| | | | | | | | | | | |
Collapse
|
8
|
Sharan M, Strobino D, Ahmed S. Intrapartum oxytocin use for labor acceleration in rural India. Int J Gynaecol Obstet 2005; 90:251-7. [PMID: 16023648 DOI: 10.1016/j.ijgo.2005.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 05/04/2005] [Accepted: 05/04/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine factors associated with the use of oxytocin for acceleration of labor in women delivered at home in rural India. METHOD Quantitative data were collected from 527 women who were delivered at home and qualitative interviews were carried out with 21 mothers and 9 birth attendants. RESULTS Oxytocin use was associated with higher education and socioeconomic status, primigravidity, and delivery by a traditional birth attendant. CONCLUSION Labor acceleration with oxytocin occurs indiscriminately In India. Oxytocin use should be regulated, and training for birth attendants should be provided as well as health education for pregnant women.
Collapse
Affiliation(s)
- M Sharan
- Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E4153, Baltimore, MD 21205, USA.
| | | | | |
Collapse
|
9
|
Ezechi OC, Kalu BKE, Nwokoro CA. Prophylactic cerclage for the prevention of preterm delivery. Int J Gynaecol Obstet 2004; 85:283-4. [PMID: 15145270 DOI: 10.1016/j.ijgo.2003.11.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2003] [Revised: 11/25/2003] [Accepted: 11/26/2003] [Indexed: 10/26/2022]
Affiliation(s)
- O C Ezechi
- Havana Specialist Hospital, Lagos, Nigeria.
| | | | | |
Collapse
|