Stillbirth and early neonatal mortality in rural Central Africa

Engmann, Cyril; Matendo, Richard; Kinoshita, Rinko; Ditekemena, John; Moore, Janet; Goldenberg, Robert L.; Tshefu, Antoinette; Carlo, Waldemar A.; McClure, Elizabeth M.; Bose, Carl; Wright, Linda L.

doi:10.1016/j.ijgo.2008.12.012

Cited by 55 publications

(87 citation statements)

References 19 publications

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“…Many different organisms have caused a stillbirth and extensive reviews regarding the types of infection, the organisms involved, the types of transmission, and mechanisms of death have been published. 16,[32][33][34] In endemic areas, malaria and syphilis are common causes of stillbirth, but in these areas and elsewhere, bacterial and viral maternal infections are often linked to stillbirth. Maternal obesity and diabetes also are risk factors for or are causal for some stillbirths.…”

Section: Cause Of Death In Stillbirths In Low-income Countriesmentioning

confidence: 99%

Stillbirths

Goldenberg

Harrison

McClure

2016

Clinics in Perinatology

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Section: Cause Of Death In Stillbirths In Low-income Countriesmentioning

confidence: 99%

Stillbirths

Goldenberg

Harrison

McClure

2016

Clinics in Perinatology

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“…Birth weight is an important proxy for viability, espe-cially where reliable gestational age determination is not available [21]. LBW and PTB are also considered to be one of the leading causes of perinatal mortality and morbidity.…”

Section: Low Birth Weight and Preterm Birthmentioning

confidence: 99%

Maternal and obstetric risk factors for low birth weight and preterm birth in rural Gambia: a hospital-based study of 1579 deliveries

Jammeh¹,

Sundby²,

Vangen³

2011

OJOG

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Introduction: Low birth weight and prematurity are risk factors for perinatal morbidity and mortality, which is high in Sub Saharan African countries. We determined the frequency of and maternal and obstetric risk factors for low birth weight and preterm birth among hospital births in rural Gambia. Method: We performed a hospital-based retrospective analysis of deliveries from July to December 2008 in two rural hospitals. Maternity records were reviewed and abstracted of the mother's demographic and reproductive characteristics, obstetric complications and foetal outcome. The maternity records contain important information maternal health and complications during pregnancy and intrapartum period. The records also contain information about the newborn's vital status and birth weight. To determine the association between low birth weight (LBW), preterm birth (PTB) and maternal demographic characteristics and obstetric complications we calculated odds using logistic regression. Main outcome measure(s): Low birth weight (<2500 grams) and preterm birth (<37 weeks). Results: Our final sample included 1244 singleton live births with complete information about all variables. The rate of LBW and PTB were 10.5% and 10.9% respectively. Ninety-four percent of LBW infants were estimated to be preterm births. The mean birth weight was 3013 g (541 g standard deviation-SD), while the mean gestational age was 37 weeks. The pattern of risk factors was similar for LBW and PTB and both were strongly associated with antepartum haemorrhage and hypertensive pregnancy disorders. Additionally, primi parity was a risk factor for both PTB and LBW. Conclusion: The percentage of low birth weight and preterm birth in rural hospitals in The Gambia is high. The most significant risk factors were those that may be detected during the antepartum period. Thus, vigilant monitoring during pregnancy, early detection and management of obstetric complications coupled with provision of timely obstetric care interventions are crucial for reducing

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“…3 Universal access to skilled birth attendance is recommended, [3][4][5] yet the quality of hospital obstetric care in sub-Saharan Africa is often reported as poor, and efforts are needed to address this contributing factor to maternal and perinatal mortality. [6][7][8][9][10][11][12][13] Prolonged labour (PL) is an important risk factor for birth-related complications, including fetal distress, which may lead to neurological damage or perinatal death, and maternal complications such as postpartum haemorrhage, uterine rupture, puerperal sepsis, and obstetric fistulae. 14,15 In these cases, access to skilled birth attendants and use of ª 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology ª 2012 RCOG the WHO's partograph are crucial to secure adequate surveillance and timely action.…”

Section: Introductionmentioning

confidence: 99%

Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion‐based audit at two Tanzanian rural hospitals

Maaløe

Sørensen

Onesmo³

et al. 2012

BJOG

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Objective To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour.Design A quality assurance analysis of a retrospective criterionbased audit supplemented by in-depth interviews with hospital staff.Setting Two Tanzanian rural mission hospitals.Population Audit of 144 cases of women undergoing caesarean sections for prolonged labour; in addition, eight staff members were interviewed.Methods Criteria of realistic best practice were established, and the case files were audited and compared with these. Hospital staff were interviewed about what they felt might be the causes for the audit findings.Main outcome measures Prevalence of suboptimal management and themes emerging from an analysis of the transcripts.Results Suboptimal management was identified in most cases. Non-invasive interventions to potentially avoid operative delivery were inadequately used. When deciding on caesarean section, in 26% of the cases labour was not prolonged, and in 16% the membranes were still intact. Of the women with genuine prolonged labour, caesarean sections were performed with a fully dilated cervix in 36% of the cases. Vacuum extraction was not considered. Amongst the hospital staff interviewed, the awareness of evidence-based guidelines was poor. Word of mouth, personal experience, and fear, especially of HIV transmission, influenced management decisions. ConclusionThe lack of use and awareness of evidence-based guidelines led to misinterpretation of clinical signs, fear of simple interventions, and an excessive rate of emergency caesarean sections.

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Stillbirth and early neonatal mortality in rural Central Africa

Cited by 55 publications

References 19 publications

Stillbirths

Stillbirths

Maternal and obstetric risk factors for low birth weight and preterm birth in rural Gambia: a hospital-based study of 1579 deliveries

Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion‐based audit at two Tanzanian rural hospitals

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