The association between preterm labour, perinatal mortality and infant death (during the first year) in Bishop Lavis, Cape Town, South Africa

Abstract

To the best of our knowledge, no information is available on perinatal, neonatal and infant mortality rates based on gestational age (GA) at delivery for any community-based cohort in South Africa (SA). In addition, birth weight is commonly used to define the lower borders of fetal viability. To distinguish between a late miscarriage and an early stillbirth, a birth weight of 500 g rather than GA of 22 weeks is often used. However, in defining stillbirth, GA is the preferred criterion with regard to the lower cut-off point, as using birth weight may exclude growth-restricted fetuses. [1] Furthermore, patients are often discharged from the delivery unit very early, and it is therefore unlikely that all neonatal deaths after discharge are accurately reported. There is also no information on the rates of late miscarriages, as this information is not prospectively collected.The true incidence of mid-trimester miscarriage is unknown. [2] Information on the incidence and causes of miscarriages may provide valuable information for programmes to reduce stillbirths. It is also necessary to analyse stillbirth and perinatal mortality rates (PNMRs) regularly to predict whether the Sustainable Development Goals for 2030 will be reached. [3] The Safe Passage Study (SPS) was undertaken in three populations, of which the 'coloured' (mixed race) population in Bishop Lavis, a suburb of Cape Town, SA, was one, to determine the role of alcohol consumption in stillbirths and sudden infant deaths. [4] Robust information on all pregnancies, from the first antenatal visit until the infant was 1 year old, allowed accurate calculation of perinatal and infant mortality. It also created an opportunity to calculate late miscarriage rates for participants who booked early and to study the role of preterm delivery in perinatal mortality and infant deaths during the first year. ObjectivesTo determine the true population-based risk of miscarriage, late stillbirth, neonatal death and preterm delivery in otherwise low-risk coloured pregnant women in a suburban area of Cape Town. MethodsThis prospective cohort study was conducted in Bishop Lavis. Recruitment was done between August 2007 and January 2015. A woman was eligible if all the following criteria were met: (i) able to provide informed consent; (ii) pregnant with one or two fetuses; (iii) ≥16 years of age; (iv) GA of at least 6 weeks and 0 days and not at the delivery admission unit; and (v) able to speak English or Afrikaans. A woman was excluded if any of the following This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The Intricate Interactions between Maternal Smoking and Drinking During Pregnancy and Birthweight Z-Scores of Preterm Births

“…Despite this being a large study with a high incidence of spontaneous preterm birth, the small numbers (and large confidence intervals) in certain smoking-drinking categories limit the strength of these findings. The prevalence rate of spontaneous preterm birth in this study was 10% in contrast to 14% in a previous study, where multiple enrolments, induced preterm birth and drug users were not excluded [20], indicating that there are also other associations with preterm birth.…”

“…Detailed information on various aspects of pregnancy, labour and neonatal outcome was collected within geographically defined communities. Analysis of the South African part of the data demonstrated a high preterm birth rate of 13.8% [20], in sharp contrast to the rate of 5.4%-8.9% for 24 European countries in 2010 [21].…”

Mesenchymal stem cell-derived secretomes for therapeutic potential of premature infant diseases

“…Another study performed by Chawanpaiboon et al [7] estimated that the global preterm birth rate was between 8.3 and 10.9% in 2000 and between 9.0 and 12.0% in 2014. Additionally, premature labor directly leads to approximately 1 million neonatal deaths annually, contributing to a major cause of childhood morbidity [8].…”

Peptidome analysis of umbilical cord mesenchymal stem cell (hUC-MSC) conditioned medium from preterm and term infants

“…The incidence of preterm birth has increased over the past 20 years in most countries [ 1 , 2 ]. Despite recent advances in perinatal medicine, severe diseases related to premature birth, including periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP), remain major causes of mortality and morbidity, which represent a heavy burden for families and society [ 3 ]. Therefore, it is an urgent and significant task to develop new safe and effective treatments to improve the prognosis of these diseases in premature infants.…”