The importance of preterm births for peri‐ and neonatal mortality in rural Malawi

Kulmala, Teija; Vaahtera, Merimaaria; Ndekha, MacDonald; Koivisto, Anna‐Maija; Cullinan, Tim; Salin, Marja-Leena; Ashorn, Per

doi:10.1046/j.1365-3016.2000.00270.x

Cited by 52 publications

(50 citation statements)

References 19 publications

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“…It is possible that the precise premature delivery rate is masked by reporting errors, since the information was based on mother's own report of gestation period which could have been inaccurate. Although other studies in sub-Saharan Africa have observed rather high premature delivery rates of up to 20 percent (Kulmala et al, 2000;Osman et al, 2001), the rates suggested in this study appalling, warranting further investigation.…”

Section: Discussioncontrasting

confidence: 64%

Poor Pregnancy Outcomes among Adolescents in South Nyanza Region of Kenya

Magadi¹

2006

African Journal of Reproductive Health

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In this paper, we examine factors associated with poor pregnancy outcomes among teenagers in South Nyanza region of Kenya. The analysis is based on a recent WHO funded study on Adolescent safe motherhood in the region, which involved a survey of 1247 adolescents aged 12-19 and in-depth interviews with 39 of the adolescents who had experienced very early pregnancies or a pregnancy wastage. The indicators of poor pregnancy outcomes analysed include pregnancy wastage and premature delivery. A striking finding is the unusually high rate of premature deliveries, especially in cases of unintended pregnancies. Analysis of the qualitative data based on in-depth interviews sheds some light on possible explanations for the poor pregnancy outcomes observed among these adolescents. In particular, unsafe abortion attempts and poor maternal health care emerge as important issues of concern. AbstractIn this paper, we examine factors associated with poor pregnancy outcomes among teenagers in South Nyanza region of Kenya. The analysis is based on a recent WHO funded study on Adolescent safe motherhood in the region, which involved a survey of 1247 adolescents aged 12-19 and in-depth interviews with 39 of the adolescents who had experienced very early pregnancies or a pregnancy wastage. The indicators of poor pregnancy outcomes analysed include pregnancy wastage and premature delivery. A striking finding is the unusually high rate of premature deliveries, especially in cases of unintended pregnancies. Analysis of the qualitative data based on in-depth interviews sheds some light on possible explanations for the poor pregnancy outcomes observed among these adolescents. In particular, unsafe abortion attempts and poor maternal health care emerge as important issues of concern.

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Section: Discussioncontrasting

confidence: 64%

Poor Pregnancy Outcomes among Adolescents in South Nyanza Region of Kenya

Magadi¹

2006

African Journal of Reproductive Health

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“…[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).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Luntamo

Kulmala²,

Mbewe³

et al. 2010

The American Society of Tropical Medicine and Hygiene

127

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Abstract. Preterm delivery, which is associated with infections during pregnancy, is common in sub-Saharan Africa. We enrolled 1,320 pregnant women into a randomized, controlled trial in Malawi to study whether preterm delivery and low birth weight (LBW) incidence can be reduced by intermittent preventive treatment of maternal malaria and reproductive tract infections. The participants received either sulfadoxine-pyrimethamine (SP) twice (controls), monthly SP, or monthly SP and two doses of azithromycin (AZI-SP). The incidence of preterm delivery was 17.9% in controls, 15.4% in the monthly SP group ( P = 0.32), and 11.8% in AZI-SP group (risk ratio = 0.66, P = 0.01). Compared with controls, those in AZI-SP group had a risk ratio of 0.61 ( P = 0.02) for LBW. Incidence of serious adverse events was low in all groups. In conclusion, the incidence of preterm delivery and LBW can in some conditions be reduced by treating pregnant women with monthly SP and two azithromycin doses.

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“…Few studies have assessed how sociodemographic patterns are related to neonatal mortality in Africa. [11][12][13][14] Previous reviews of the causes of neonatal deaths have demonstrated that up to 70 per cent of neonatal mortality could be prevented using evidence-based interventions. To adopt a focused, evidence-based approach to reduce neonatal mortality in Swaziland, a clear understanding of the associated factors is necessary.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing neonatal mortality: an analysis using the Swaziland Demographic Health Survey 2007

Zwane

Masango

2012

J Public Health Africa

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This study examines the effects of socioeconomic and maternal variables on the probability of neonatal deaths. An understanding of the factors related to neonatal mortality is important in guiding the development of focused and evidence-based health interventions to prevent neonatal deaths. The data source for the analysis was the 2006-07 Swaziland Demographic and Health Survey from which survival information on 1727 infants born within the 3 years preceding the survey. Design based logistic regression incorporating survey weights was performed to analyze the associated factors. Compared to infants born at home, the odds of dying were significantly lower for infants born in a private facility (OR=0.37, 95% CI: 0.15-0.90). Neonates born in public facilities and those born at home had similar odds of dying. For newborns, whose birth size according to the mother was smaller than average, the odds of dying were more than 4 times the odds for large-sized babies (OR=4.72, 95% CI: 1.66-13.36).

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The importance of preterm births for peri‐ and neonatal mortality in rural Malawi

Cited by 52 publications

References 19 publications

Poor Pregnancy Outcomes among Adolescents in South Nyanza Region of Kenya

Poor Pregnancy Outcomes among Adolescents in South Nyanza Region of Kenya

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

Factors influencing neonatal mortality: an analysis using the Swaziland Demographic Health Survey 2007

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