Perinatal outcome in an obstetric cohort of Mozambican women

Abstract

A prospective cohort of 908 consecutively enrolled pregnant women with biparietal diameter (DBP) compatible with gestational age equal to or below 21 weeks were followed up regularly at 2-4 weeks intervals. Normal antenatal care routine was applied. The newborns were followed until 7 days postpartum. The setting was two suburban antenatal clinics in Maputo and the delivery ward at the Maputo Central Hospital. The main outcome variables were low birth weight (LBW), preterm delivery, intrauterine fetal death, perinatal death and small for gestational age (SGA). For each of these variables the odds ratio for maternal risk factors was estimated with 95 per cent confidence interval and multiple logistic regression analysis was used. LBW occurred in 16.2 per cent and low maternal weight, low weight gain during pregnancy and not having a living child were risk factors. Prevalence of preterm birth was 15.4 per cent and low weight gain during pregnancy and malaria in the perinatal period were risk factors. Four per cent of mothers delivered stillborns and syphilis serology (positive VDRL test) was a risk factor. Perinatal death occurred in 4.7 per cent. These deaths were associated with being SGA, LBW or preterm at birth. Of the cohort women, 9.7 per cent delivered SGA newborns. It was concluded that maternal constitutional factors, particularly maternal weight gain, maternal height and maternal weight as well as syphilis and malaria during pregnancy, need to be given attention concerning the adverse outcomes addressed. The establishment of an obstetric cohort, followed prospectively, was possible in a low-income setting with limited numbers lost to follow-up at delivery.

Incidence and determinants of stillbirth amongst parturients in two hospitals in Southern Nigeria

“…[9] Extremes of parity were associated with higher rates of fetal mortality, with nulliparous parturients having stillbirth rate higher than others. The finding that FMR is high in the grand-multiparous parturients compares favorably with reports from other centers across the country and beyond, [22,28,29] while the higher rate of fetal mortality associated with nulliparous parturients is a unique finding of this study as previous report shows a low FMR in this category. [22,28,29] Marital status was also shown to be strongly correlated with the risk of fetal death with higher stillbirth rates in single mothers who are most likely to be less than 20 years of age.…”

Effect of Repeated Treatment of Pregnant Women with Sulfadoxine-Pyrimethamine and Azithromycin on Preterm Delivery in Malawi: A Randomized Controlled Trial

“…[2][3][4][5] Because of a predicted increase in bed net use, we estimated this proportion to be 18% in the control group. Assuming a 10% loss to follow-up, we calculated that a sample size of 440 pregnant women per group would give 80% power at a 5% level of significance to detect a 40% reduction in the rate of preterm delivery (birth before 37 completed gestation weeks).…”

“…[2][3][4][5] In industrialized countries, preterm delivery accounts for 75% of perinatal mortality and a large part of serious neonatal morbidity. 6 Additionally, it is associated with low birth weight (LBW, birth weight less than 2,500 grams) and a variety of more chronic conditions such as impaired lung and eye function, and neurologic and psychological problems.…”

“…In subSaharan Africa, maternal malaria parasitemia and reproductive tract infections (RTIs) are believed to account for a large part of preterm delivery and LBW. 3,4,[12][13][14] Therefore, several countries in Africa offer intermittent preventive treatment (IPT) for malaria with two doses of sulfadoxinepyrimethamine (SP) to all pregnant women. 15 However, the efficacy of this intervention has been questioned and more frequent dosing and other treatment regimens have been suggested.…”

An evaluation of stillbirths in İstanbul by examining death certificates

“…However, there is no definite diagnostic test to support this view. Cord blood gases, Apgar score, and clinical evaluation are insufficient to help in the diagnosis (26). We could also not make an evaluation in this issue in our study.…”