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Born before arrival (BBA) in Trinidad-a seven year case-control study
S Ramsewak1, G Narayansingh, D Thomas
1The University of the West Indies, Trinidad.
Summary
Babies born before arrival (BBA) were more common in Afro-Caribbean women, grand multiparous women, and those with poor antenatal care, leading to higher perinatal mortality. Identifying high-risk mothers can help prevent BBA and its serious consequences.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Neonatal Care
Background:
- Births occurring before arrival (BBA) at a healthcare facility present significant risks to both mother and infant.
- Understanding the specific risk factors for BBA in diverse populations is crucial for targeted prevention strategies.
- Previous research has identified various contributing factors, but context-specific data, particularly from developing countries, is essential.
Purpose of the Study:
- To investigate the risk factors associated with babies born before arrival (BBA) in a Caribbean developing country.
- To compare the incidence of BBA and associated perinatal outcomes between different ethnic groups and maternal characteristics.
- To identify clinical features that can predict high-risk pregnancies for BBA.
Main Methods:
- A retrospective case-control study involving 326 babies born before arrival (BBA).
- Matching of BBA cases with hospital-delivered controls based on delivery week.
- Control groups were matched by maternal age and parity (Control group 1) or gestational age and fetal birth weight (Control group 2).
Main Results:
- Babies born before arrival (BBA) occurred significantly more frequently in Afro-Caribbean mothers compared to Indo-Caribbean mothers.
- Grand multiparity, poor antenatal care, and a history of previous BBA were significantly associated with BBA.
- Perinatal mortality was higher in the BBA group compared to control groups.
- Unlike some studies, young maternal age and marital status were not found to be significant risk factors in this population.
Conclusions:
- Specific clinical features, including ethnicity, parity, antenatal care utilization, and prior BBA history, can identify women at high risk.
- These findings can aid in the development of targeted interventions to prevent BBA and mitigate its adverse perinatal outcomes.
- The study highlights the importance of culturally and socioeconomically tailored approaches to BBA prevention in developing regions.