Recurrence of adverse perinatal outcomes in developing countries

Ouyang, Fengxiu; Zhang, Jun; Betrán, Ana Pilar; Yang, Zujing; Souza, João Paulo; Merialdi, Mario

doi:10.2471/blt.12.111021

Cited by 49 publications

(49 citation statements)

References 30 publications

(38 reference statements)

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“…This is similar to an estimated 2.8-fold risk in a recent report using survey data on maternal and perinatal health data from developing countries [25]. …”

Section: Discussionsupporting

confidence: 88%

Recurrence of perinatal death in Northern Tanzania: a registry based cohort study

Mahande

Daltveit

Mmbaga

et al. 2013

BMC Pregnancy Childbirth

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BackgroundPerinatal mortality is known to be high in Sub-Saharan Africa. Some women may carry a particularly high risk which would be reflected in a high recurrence risk. We aim to estimate the recurrence risk of perinatal death using data from a hospital in Northern Tanzania.MethodsWe constructed a cohort study using data from the hospital based KCMC Medical Birth Registry. Women who delivered a singleton for the first time at the hospital between 2000 and 2008 were followed in the registry for subsequent deliveries up to 2010 and 3,909 women were identified with at least one more delivery within the follow-up period. Recurrence risk of perinatal death was estimated in multivariate models analysis while adjusting for confounders and accounting for correlation between births from the same mother.ResultsThe recurrence risk of perinatal death for women who had lost a previous baby was 9.1%. This amounted to a relative risk of 3.2 (95% CI: 2.2 - 4.7) compared to the much lower risk of 2.8% for women who had had a surviving baby. Recurrence contributed 21.2% (31/146) of perinatal deaths in subsequent pregnancies. Preeclampsia, placental abruption, placenta previa, induced labor, preterm delivery and low birth weight in a previous delivery with a surviving baby were also associated with increased perinatal mortality in the next pregnancy.ConclusionsSome women in Tanzanian who suffer a perinatal loss in one pregnancy are at a particularly high risk of also losing the baby of a subsequent pregnancy. Strategies of perinatal death prevention that target pregnant women who are particularly vulnerable or already have experienced a perinatal loss should be considered in future research.

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“…This is similar to an estimated 2.8-fold risk in a recent report using survey data on maternal and perinatal health data from developing countries [25]. …”

Section: Discussionsupporting

confidence: 88%

Recurrence of perinatal death in Northern Tanzania: a registry based cohort study

Mahande

Daltveit

Mmbaga

et al. 2013

BMC Pregnancy Childbirth

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“…Stillbirth is the end point of multiple processes, including placental dysfunction. There are a number of stillbirth classification schemes in use that assign cause of death and/or factors contributing to stillbirth . Common causes or factors associated with stillbirth include congenital malformations, infection, hypoxia, fetal growth disorders, and PTB, and by identifying the cause of stillbirth, targeting interventions could be applied …”

Section: Discussionmentioning

confidence: 99%

Risk of stillbirth, preterm delivery, and fetal growth restriction following exposure in a previous birth: systematic review and meta‐analysis

Malacova

Regan

Nassar

et al. 2017

BJOG

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Why and how was the study carried out? Each year, around 2.6 million babies are stillborn, 15 million are born preterm (<37 weeks of gestation), and 32 million are born small for gestational age (less than tenth percentile for weight, smaller than usually expected for the relevant pregnancy stage). Being born preterm or small for gestational age can increase the chance of long-term health problems. The effect of having a stillbirth, preterm birth, or small-for-gestational-age infant in a previous pregnancy on future pregnancy health has not been summarised. We identified 3399 studies of outcomes of previous pregnancies, and 17 were summarised by our study. What were the main findings? The outcome of the previous pregnancy influenced the risk of poor outcomes in the next pregnancy. Babies born to mothers who had a previous preterm birth or small-for-gestational-age birth were more likely to be stillborn. The smaller and the more preterm the previous baby, the higher the risk of stillbirth in the following pregnancy. The risk of stillbirth in the following pregnancy was doubled if the previous baby was born both preterm and small for gestational age. Babies born to mothers who had a previous stillbirth were more likely to be preterm or small for gestational age. What are the limitations of the work? We included a small number of studies, as there are not enough studies in this area (adverse birth outcomes followed by adverse cross outcomes in the next pregnancy). We found very few studies that compared the risk of small for gestational age after preterm birth or stillbirth. Definitions of stillbirth, preterm birth categories, and small for gestational age differed across studies. We did not know the cause of stillbirth for most studies. What are the implications for patients? Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes.

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“…[8][9][10][11][12][13][14][15][16][17] Knowledge of the causes and risk factors of this tragic public health challenge will help in designing preventive measures to reduce its incidence. [18][19][20][21] It is against this backdrop that we embarked on this study with the overall goal of determining the incidence of stillbirth and the socio-demographic and clinical variables associated with fetal deaths among parturients at the Central Hospital Warri and General Hospital, Ekpan in Delta state.…”

Section: Introductionmentioning

confidence: 99%

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

OmoâAghoja

Onohwakpor

Adeyinka

et al. 2014

J Basic Clin Reprod Sci

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A B S T R A C TBackground: Fetal death is a major but often overlooked public health issue. Aim: Knowledge of the causes and risk factors will help in designing measures to reduce the burden of fetal death in Nigeria. Materials and Methods: A 5 year descriptive study of all fetal mortality of >28 weeks in Southern Nigeria. Relevant details were extracted from the case notes and the registers in the labor ward, maternity ward, the labor ward theater and the main theater. Statistical Analysis Used: The data was analyzed using Statistical Package for Social Scientist (SPSS PC+) and this consisted of univariate analysis and comparisons of identified relationships. Results: The total number of deliveries from 28 weeks was 25,780 and the number of parturients with fetal mortality after 28 weeks was 157 and therefore the incidence of stillbirth was 0.6% giving a mortality rate of 6.1/1000 total births. However, 148 (85%) case notes of the total fetal deaths were retrieved and formed the study sample. Socio-demographic variables such as extremes of age and parity, unbooked status, unemployment, unmarried, Isoko, Itsekiri and Ijaw ethnic groups and primary level or no formal education were determinants of stillbirth. Others were maternal diabetes mellitus, malaria, hypertension, labor duration >4 h, instrumental or assisted vaginal delivery, gestational age at booking >12 weeks, low birth weight and preterm births. Conclusion: The fetal mortality (stillbirth) rate was low and the determinants were identified. Public health education, female education and socio-economic empowerment are suggested preventive measures.

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Recurrence of adverse perinatal outcomes in developing countries

Cited by 49 publications

References 30 publications

Recurrence of perinatal death in Northern Tanzania: a registry based cohort study

Recurrence of perinatal death in Northern Tanzania: a registry based cohort study

Risk of stillbirth, preterm delivery, and fetal growth restriction following exposure in a previous birth: systematic review and meta‐analysis

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

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