Background
Adequate antenatal care (ANC) services are key for early identification of pregnancy related risk factors and maintaining women’s health during pregnancy. This study aimed to assess the influence of ANC provided by the Medical Mission Primary Health Care Suriname (MMPHCS) and of ethnicity on adverse birth outcomes in Tribal and Indigenous women living in Suriname’s remote tropical rainforest interior.
Method
From April 2017 to December 2018 eligible Tribal and Indigenous women with a singleton pregnancy that received ANC from MMPHCS were included in the study. Data on low birth weight (LBW < 2500 g), preterm birth (PTB < 37 weeks), low Apgar score (< 7 at 5 min), parity (≤1 vs. > 1) and antenatal visits utilization (≥8 vs. < 8) in 15 interior communities were retrospectively analyzed using descriptive statistics, crosstabs and Fisher’s exact tests.
Results
A total of 204 women were included, 100 (49%) were Tribal, mean age was 26 ± 7.2 years and 126 women (62%) had 8 or more ANC visits. One participant had a miscarriage; 22% had adverse birth outcomes: 16 (7.9%) LBW and 30 (14.8%) PTB; 7 women had a child with both PTB and LBW; 5 women had stillbirths. None of the newborns had low Apgar scores. Maternal age, ethnicity, ANC and parity were associated with PTB (χ2 = 8,75, p = 0.003, χ2 = 4,97, p = 0.025, χ2 = 17,45, p < 0.001, χ2 = 11,93, p < 0.001 respectively).
Conclusion
Despite an almost 100% study adherence over one fifth of women that received ANC in the interior of Suriname had adverse birth outcomes, in particular PTB and LBW. Younger nulliparous Indigenous women with less than the recommended 8 ANC visits had a higher risk for PTB. The rate of adverse birth outcomes highlights the need for further research to better assess factors influencing perinatal outcomes and to put strategies in place to improve perinatal outcomes. Exposure assessment of this sub-cohort and neurodevelopment testing of their children is ongoing and will further inform on potential adverse health effects associated with environmental exposures including heavy metals such as mercury and lead.
PurposeThis study investigates the prevalence of anemia in young children living in the interior of Suriname and the influence of the associated factors age, nutritional status and ethnicity.ResultsIn this cross-sectional observational study, 606 children aged 1–5 years from three different regions of Suriname’s interior were included, and hemoglobin levels and anthropometric measurements were collected. Logistic regression models were computed to examine independent associations between anemic and nonanemic groups and to measure the influence of age, nutritional status and ethnicity.ResultsA total of 606 children were included, of whom 330 (55%) were aged 1–3 years and 276 were aged 4–5 years. The overall prevalence of anemia was 63%. Younger age was associated with anemia (odds ratio [OR]=1.78; 95% confidence interval [CI]: 1.27–2.51). Anemia was less prevalent in Amerindian than in Maroon children (OR=0.51; 95% CI: 0.34–0.76). Hemoglobin level was not influenced by nutritional status nor by sex.ConclusionThe prevalence of anemia in children aged 1–5 years living in Suriname’s interior is high (63%) compared to that in similar aged children in Latin America and the Caribbean (4–45%). Children aged 1–3 years were more affected than those aged 4–5 years as were Maroon children compared to Amerindian children. Nutritional status and sex were not of influence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.