The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa

Beauclair, Roxanne; Petro, Gregory; Myer, Landon

doi:10.1186/1471-2393-14-204

Cited by 38 publications

(28 citation statements)

References 28 publications

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“…20,21 Nationwide coverage and utilization of ANC and a functioning referral system to the tertiary level hospital in Somaliland would most likely save lives in line with findings from other African studies. 6,[8][9][10][17][18][19] Regarding referral, the families had brought the woman to the referral hospital bypassing the ANC, in this study. Some did not bypass the ANC but they did not get referred to the tertiary level hospital, so the families brought them, and the question arise of how the health system can deliver appropriate care at the right level.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad

Erlandsson¹

2017

MOJWH

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Background: Somalia is one of 13 countries in Africa with stillbirth rates of more than 30 per 1000 total birth. To our knowledge no study in Somaliland has focused on the mother-baby dyad regarding risk factors for stillbirth. The objective of this study was to identify frequency, causes and beliefs for stillbirth in mothers with life threatening conditions as a pilot for a potential nationwide near-miss study with full coverage in the Somaliland health care system. Method: A prospective cross sectional study using the WHO near-miss questionnaire in a tertiary level hospital with 1.385 deliveries during a five months period in 2015. Results: Out of 138 near miss and death events 22% (n=30) had a stillbirth. Seventyseven percent (77%) of the mothers (n=23) with stillborn babies survived and 23% died (n=7). They were diagnosed with life threatening conditions, possible to prevent, on arrival at the tertiary hospital. None of them developed the maternal complication/s during the hospital stay. Cesarean sections (43%) were performed within three hours after arrival. Beliefs regarding the stillbirth for the near miss women were that holding the baby born death helps them cope with the loss (74%) and that religious believes helps them cope faster with the loss (91%). Conclusion and clinical implications: The near miss women, their families, TBAs and SBAs might need better information of what causes a stillbirth, how they could prevent it and about the near miss women's beliefs surrounding stillbirth to enable them to communicate this to pregnant women and prevent delay in admission to the tertiary level hospital. Furthermore, this pilot study suggest that the "Near Miss Questionnaire" could be used in low-and middle income settings to detect a full picture of the situation with stillbirth in a country.

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Section: Discussionmentioning

confidence: 99%

“…However, when it comes to stillbirth early ANC compared to ANC initiation in the third trimester might not make any difference in low-resource settings. 10 It has been suggested from WHO that from 2015 an onwards the mother-baby dyad must be applied. 11 A healthy mother is more unlikely to get a stillborn.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad

Erlandsson¹

2017

MOJWH

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“…The importance of early attendance at ANC cannot be overstated. Late attendance at ANC has been associated with an increased risk of maternal and fetal complications, including low birth weight, premature delivery, and stillbirth [18,19]. Early initiation of ANC is crucial to ensure pregnant women receive health education and preventive services, such as iron supplementation, tetanus injection, and deworming, as well as early implementation of IPTp, which has been shown to have a greater impact than later administration [20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

A Cluster Randomized Trial of Delivery of Intermittent Preventive Treatment of Malaria in Pregnancy at the Community Level in Burkina Faso

Gutman¹,

Stephens

Tiendrebéogo³

et al. 2020

Preprint

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Background Malaria in pregnancy is responsible for 8–14% of low birth weight and 20% of stillbirths in sub-Saharan Africa. To prevent these adverse consequences, the World Health Organization recommends intermittent preventive treatment of pregnant women (IPTp) with sulfadoxine-pyrimethamine be administered at each ANC visit starting as early as possible in the second trimester. Global IPTp coverage in targeted countries remains unacceptably low. Community delivery of IPTp was explored as a means to improve coverage. Methods A cluster randomized, controlled trial was conducted in 12 health facilities in a 1:1 ratio to either an intervention group (IPTp delivered by CHWs) or a control group (standard practice, with IPTp delivered at HFs) in three districts of Burkina Faso to assess the effect of IPTp administration by community health workers (CHWs) on the coverage of IPTp and antenatal care (ANC). The districts and facilities were purposively selected taking into account malaria epidemiology, IPTp coverage, and the presence of active CHWs. Pre- and post-intervention surveys were carried out in March 2017 and July–August 2018, respectively. A difference in differences (DiD) analysis was conducted to assess the change in coverage of IPTp and ANC over time, accounting for clustering at the health facility level. Results Altogether 374 and 360 women were included in the baseline and endline surveys, respectively. At baseline, women received a median of 2.1 doses; by endline, women received a median of 1.8 doses in the control group and 2.8 doses in the intervention group (p-value <.0001). There was a non-statistically significant increase in the proportion of women attending four ANC visits in the intervention compared to control group (DiD= 12.6%, p-value= 0.16). By the endline, administration of IPTp was higher in the intervention than control, with a DiD of 17.6% for IPTp3 (95% confidence interval (CI) -16.3, 51.5; p-value 0.31) and 20.0% for IPTp4 (95% CI -7.2, 47.3; p-value= 0.15). Conclusions Community delivery of IPTp could potentially lead to a greater number of IPTp doses delivered, with no apparent decrease in ANC coverage.

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“…Several studies addressed the ability of preventing and avoiding the majority of the previous risk factors by provide good level of antenatal care (ANC), where good level of antenatal care help in controlling a lot of factors (blood sugar level, blood pressure), earlier diagnosis of congenital anomalies, prescribe folic Acid, which provide a good chance to early referral to good center for C/S section in high risk cases [7] [9]. The authors in Ethiopia study recorded that the variety in ANC care between urban & rural areas induced difference rate of IUFD cases [2].…”

Section: Discussionmentioning

confidence: 99%

Conditions Associated with Intrauterine Fetal Demise (IUFD) in Pregnant Women at King Abdulaziz University (KAUH). A Five-Year Experience

Kafy¹,

Oraif²

2017

OJOG

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Background: Intrauterine fetal demise is the death of the fetus after twenty week of gestation but before the onset of labor. In more than 50% of cases, the etiology of antepartum fetal death is not known or cannot be determined. Several factors attributed to the risk of IUFD. This study aimed to determine the incidence of IUFD, as well as associated conditions. Method: This retrospective study enrolled all pregnant women who attending at KAUH between 2011 and 2015. Results: During the last five years 248 verified IUFD cases were reported, the mean age was 30.59. Saudi nationality represented by 27 %. PET was represented 17.7% and congenital malformation was represented by 7.3% as risk factors. Regarding the mode of delivery SVD was 58.9% followed by CS 28.6. Conclusion: Stillbirth is an unfavorable event, there are several factors (maternal, fetal & placenta) associated with IUFD. Providing good level of antenatal care helped in reducing IUFD incidence.

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The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa

Cited by 38 publications

References 28 publications

Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad

Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad

A Cluster Randomized Trial of Delivery of Intermittent Preventive Treatment of Malaria in Pregnancy at the Community Level in Burkina Faso

Conditions Associated with Intrauterine Fetal Demise (IUFD) in Pregnant Women at King Abdulaziz University (KAUH). A Five-Year Experience

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