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Published on: January 12, 2018
Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
Alexandra Vasconcelos1, Swasilanne Sousa2, Nelson Bandeira3
1Instituto de Higiene e Medicina Tropical (IHMT), Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Universidade NOVA de Lisboa, Lisboa, Portugal.
Insights
Adverse birth outcomes (ABOs) are linked to twin pregnancies and prolonged rupture of membranes. High-quality antenatal care (ANC) significantly reduces ABO risk in newborns.
Area of Science:
- Neonatal Health
- Obstetrics
- Public Health
Background:
- Adverse birth outcomes (ABOs) increase newborn mortality and long-term health issues.
- Identifying factors associated with ABOs is crucial for effective interventions.
- This study focused on ABOs in Sao Tome & Principe, a resource-limited sub-Saharan African country.
Purpose of the Study:
- To assess factors associated with adverse birth outcomes (ABOs) in newborns.
- To inform targeted interventions in resource-constrained settings.
Main Methods:
- A hospital-based, unmatched case-control study was conducted.
- Newborns with one or more ABOs were cases; healthy newborns were controls.
- Data were collected via interviews and medical records; multivariable logistic regression was used.
Main Results:
- Twin pregnancy (aOR 4.92), prolonged rupture of membranes (aOR 3.43), and meconium-stained fluid (aOR 1.59) were significantly associated with ABOs.
- Eight or more antenatal care (ANC) contacts were protective against ABOs (aOR 0.33).
Conclusions:
- Modifiable factors linked to ABOs necessitate cost-effective interventions.
- Prioritizing high-quality ANC is essential.
- Twin pregnancies and intrapartum complications require prompt attention and follow-up.
Background:
Newborns with one-or-more adverse birth outcomes (ABOs) are at greater risk of mortality or long-term morbidity with health impacts into adulthood. Hence, identifying ABO-associated factors is crucial for devising relevant interventions. For this study, ABOs were defined as prematurity (PTB) for gestational age <37 weeks, low birth weight (LBW) <2.5 kg, macrosomia >4 kg, asphyxia for a 5-minute Apgar score <7, congenital anomalies, and neonatal sepsis. This study aimed to assess factors associated with ABOs among babies delivered at the only hospital of Sao Tome & Principe (STP), a resource-constrained sub-Saharan-Central African country.
Methods:
A hospital-based unmatched case‒control study was conducted among newborns from randomly selected mothers. Newborns with one-or-more ABO were the cases (ABO group), while healthy newborns were the controls (no-ABO group). Data were collected by a face-to-face interview and abstracted from antenatal care (ANC) pregnancy cards and medical records. Multivariable logistic regression analysis was performed to identify ABO-associated factors considering a level of significance of α = 0.05.
Results:
A total of 519 newborns (176 with ABO and 343 no-ABO) were enrolled. The mean gestational age and birthweight of cases and controls were 36 (SD = 3.7) weeks with 2659 (SD = 881.44) g and 39.6 (SD = 1.0) weeks with 3256 (SD = 345.83) g, respectively. In the multivariable analysis, twin pregnancy [aOR 4.92, 95% CI 2.25-10.74], prolonged rupture of membranes [aOR 3.43, 95% CI 1.69-6.95], and meconium- fluid [aOR 1.59, 95% CI 0.97-2.62] were significantly associated with ABOs. Eight or more ANC contacts were found to be protective [aOR 0.33, 95% CI 0.18-0.60, p<0.001].
Conclusion:
Modifiable factors were associated with ABOs in this study and should be considered in cost-effective interventions. The provision of high-quality ANC should be a priority. Twin pregnancies and intrapartum factors such as prolonged rupture of membranes and meconium-stained amniotic fluid are red flags for ABOs that should receive prompt intervention and follow-up.
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