Maternal complications and neonatal outcome in Arab women of a fast developing country

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 1st 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.

The impact of the interpregnancy interval on birth weight and other pregnancy outcomes

“…A previous study by Bener et al 11 discovered that maternal complications affected both the mother and the risk of neonatal morbidity and mortality. A birth spacing program using contraceptives is not encouraged for Arab women and the interpregnancy interval has been reported as an important factor for the mother and child.…”

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

“…Environmental exposures included smoking and secondhand smoking [49,56], and all six studies on anthropometric measures were on BMI (Table 1 and see Additional file 3: Table S2). [47,50,53,54,83,111,113], and maternal anemia in three cohort studies [50,104,113]. Postpartum depression was explored in only one prospective cohort study in the UAE [76].…”

“…Summary of the reviewed 81 published cohort studies according to the measured six exposure and two outcome domainsSociodemographic exposuresMaternal age was a common measured sociodemographic exposure studied in 18 cohort studies. Advanced maternal age was associated with GDM, CS, and preterm delivery[51,53,58,92,111,113]. Primary education or less was independently associated with 69% lower likelihood of exclusive breastfeeding at 6 months (aOR, 0.31; 95% CI, 0.11-0.88)[58] (see Additional file 3:Table S2).…”

“…,43-50, 56, 57, 62-72, 79, 80, 82-98, 105-112], followed by eight (9.9%) in Kuwait[20,21,24,41,51,73,81,99], seven (8.6%) in each of Qatar[42,52,53,60,61,74,113] and the UAE[58, 59, 75-77, 100, 101], six (7.4%) in Oman…”

Maternal mortality and health in the Arab World: A 25‐year epidemiological study

“…Pregnancy and birth related complications are the leading cause of disability and mortality among women of child‐bearing age in developing countries, ranking even above cardiovascular disease and cancer related deaths . The most common causes of maternal mortality are hemorrhage, hypertension, sepsis, abortive outcomes and embolism .…”