scholarly journals Determinants of preterm birth in public hospitals in central Ethiopia: an unmatched case-control study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 773
Author(s):  
Berhanu Senbeta Deriba ◽  
Agumas Fentahun Ayalew ◽  
Addis Adera Gebru

Background: Around 15 million babies are born prematurely in the world every year. The most common cause of neonatal death in Ethiopia is premature birth. To reduce the rate of preterm delivery by correcting modifiable or preventable causes, the availability of local data is important. Hence, this study aimed to identify the determinants of preterm birth among women who gave birth in public hospitals in central Ethiopia. Methods: An Institutional-based unmatched case-control study was conducted at public hospitals in central Ethiopia to select 170 cases and 340 controls. The collected data were entered into EPI INFO and transferred to SPSS for analysis. Tables, graphs, and proportions were used to present the results. Binary and multiple logistic regressions analysis were computed to identify determinants of preterm birth. Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI), and a p-value < 0.05 were computed to determine the presence of an association between preterm birth and independent variables. Results: A total of 166 cases and 332 controls participated in the study, giving a response rate of 97.6%. Cigarette smoking (AOR=3.77, 95% CI=1.35,10.56), alcohol consumption (AOR=1.85, 95% CI=1.11,3.10), wanted but unplanned pregnancy (AOR=3,95% CI=1.68,5.34), neither wanted nor planned pregnancy(AOR=3.61% CI=1.62,8.06), lack of antenatal care (ANC) visits (AOR=4.13, 95% CI=1.95, 8.74), adverse birth outcomes (AOR=5.66, 95% CI=2.88,11.12), presence of a diagnosed illness (AOR=2.81, 95% CI=1.37, 5.76), presence of one or more of obstetrics complications(AOR=6.44, 95% CI=5.49, 3.35, 9), and hemoglobin level < 11g/dl  (AOR=2.78, 95% CI=1.48, 5.22) were determinants of preterm birth. Conclusion:-In this study, cigarette smoking status, alcohol drinking status, pregnancy status, adverse birth outcomes, ANC visits, obstetric complications,  presence of medical illness, and anemia were identified as determinants of preterm birth. It is important to encourage such women to attend ANC visits, stop smoking, and abstain from alcohol.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan E. Smithmyer ◽  
Chileshe M. Mabula-Bwalya ◽  
Humphrey Mwape ◽  
Gabriel Chipili ◽  
Bridget M. Spelke ◽  
...  

Abstract Background Maternal HIV increases the risk of adverse birth outcomes including preterm birth, fetal growth restriction, and stillbirth, but the biological mechanism(s) underlying this increased risk are not well understood. We hypothesized that maternal HIV may lead to adverse birth outcomes through an imbalance in angiogenic factors involved in the vascular endothelial growth factor (VEGF) signaling pathway. Methods In a case–control study nested within an ongoing cohort in Zambia, our primary outcomes were serum concentrations of VEGF-A, soluble endoglin (sEng), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFLT-1). These were measured in 57 women with HIV (cases) and 57 women without HIV (controls) before 16 gestational weeks. We used the Wilcoxon rank-sum and linear regression controlling for maternal body mass index (BMI) and parity to assess the difference in biomarker concentrations between cases and controls. We also used logistic regression to test for associations between biomarker concentration and adverse pregnancy outcomes (preeclampsia, preterm birth, small for gestational age, stillbirth, and a composite of preterm birth or stillbirth). Results Compared to controls, women with HIV had significantly lower median concentrations of PlGF (7.6 vs 10.2 pg/mL, p = 0.02) and sFLT-1 (1647.9 vs 2055.6 pg/mL, p = 0.04), but these findings were not confirmed in adjusted analysis. PlGF concentration was lower among women who delivered preterm compared to those who delivered at term (6.7 vs 9.6 pg/mL, p = 0.03) and among those who experienced the composite adverse birth outcome (6.2 vs 9.8 pg/mL, p = 0.02). Median sFLT-1 concentration was lower among participants with the composite outcome (1621.0 vs 1945.9 pg/mL, p = 0.04), but the association was not significant in adjusted analysis. sEng was not associated with either adverse birth outcomes or HIV. VEGF-A was undetectable by Luminex in all specimens. Conclusions We present preliminary findings that HIV is associated with a shift in the VEGF signaling pathway in early pregnancy, although adjusted analyses were inconclusive. We confirm an association between angiogenic biomarkers and adverse birth outcomes in our population. Larger studies are needed to further elucidate the role of HIV on placental angiogenesis and adverse birth outcomes.


2018 ◽  
Author(s):  
Elias Bekele Wakwoya ◽  
Tariku Dingeta Amante ◽  
Kassahun Fikadu Tesema

Background - Gestational diabetes mellitus is any degree of glucose intolerance at onset or first recognition during pregnancy. A pregnant woman with diabetes and her unborn child are at increased risk of pregnancy complications and adverse neonatal outcomes. The aim of this study was to assess the association of gestational diabetes mellitus and adverse birth outcomes among women who gave birth in Eastern Ethiopia. Method – Unmatched case control study design was conducted in Hiwot Fana Specialized University Hospital and Dilchora Hospital from December 2015 to April 2017. This study involved a total of 1,834 mothers and their babies. A structured and pre-tested questionnaire was used to collect the socio-demographic data. Mothers who had risk factor for gestational diabetes were screened by oral glucose tolerance tests. Adverse birth outcomes were observed and registered after delivery. Multivariate logistic regression analysis was employed to identify predictors of adverse birth outcome. P value less than 0.05 was considered to decide statistical significance. Results: From a total of 1,834 mothers 47 (2.6%) of them were found to have gestational diabetes. In binary logistic regression analysis macrosomia and still were found to have an association with gestational diabetes, COR=11[95% CI = 5.7-21.2] and COR= 2.9[95% CI = 1.02-8.5] respectively. Macrosomia was independently associated with GDM and babies born to mothers with gestational diabetes. Babies born from mothers with gestational diabetes were 8.5 times more likely to have macrosomia than babies born to non-diabetic mothers, AOR = 8.5 [95% CI = 5.7-21.4]. Conclusion: This study revealed that only macrosomia was strongly associated with gestational diabetes and this finding is coherent with studies done at different parts of the world. Early screening and treatment of mothers with GDM can minimize the adverse birth outcomes, therefore routine screening service for pregnant women who are at risk of developing gestational diabetes must exist at all health facilities in Ethiopia.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Berhanu Senbeta Deriba ◽  
Gizachew Abdissa Bulto ◽  
Elias Teferi Bala

Background. Anemia is a major public health problem in both developed and developing countries especially among pregnant women. Nearly half of pregnant women in Ethiopia have anemia which has both health and economic impacts. Therefore, this study is aimed at identifying nutritional-related predictors of anemia among pregnant women attending antenatal care in Central Ethiopia, 2019. Methods. An unmatched case-control study was conducted at public hospitals in Central Ethiopia from February to April 2019. The consecutive sampling technique was used to select study participants. Data were collected by a structured questionnaire, and the collected data were entered into Epi Info version 7 and SPSS version 23 for analysis. Binary and multiple logistic regression analyses were computed to identify predictors of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 was used to determine the presence of an association. Result. A total of 426 pregnant women (142 cases and 284 controls) had participated in this study. Taking tea/coffee immediately after food ( AOR = 2.35 , 95% CI: 1.39-3.99), mid-upper arm circumference (MUAC) of mothers of <23 centimeters ( AOR = 3.83 , 95% CI: 2.26-6.49), the presence of forbidden food during pregnancy ( AOR = 2.21 , 95% CI: 1.24-3.88), not taking additional food ( AOR = 1.99 , 95% CI: 1.17-3.40), unable to take fruit ( AOR = 4.05 , 95% CI: 1.3-15.47), loss of appetite ( AOR = 2.28 , 95% CI: 1.28-4.09), low dietary diversity score (DDS) ( AOR = 3.29 , 95% CI: 1.83-5.90), and medium DDS ( AOR = 2.88 , 95% CI: 1.46-5.70) were found to be determinants of anemia. Conclusions. Taking tea or coffee immediately after food, MUAC of mothers, the presence of forbidden food, not taking additional food, frequency of taking fruit, and dietary diversity were predictors of anemia among pregnant women. Therefore, interventions targeted at prevention of anemia among pregnant mothers should emphatically consider those identified determinants. This finding also highlights the need for strong nutritional counseling to prevent anemia among pregnant mothers during antenatal care follow-ups along with other interventions.


Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Berhanu Senbeta Deriba ◽  
Elias Teferi Bala ◽  
Gizachew Abdissa Bulto ◽  
Tinsae Abeya Geleta ◽  
Agumas Fentahun Ayalew ◽  
...  

Introduction. Anemia is highly dominant among pregnant women due to the need for iron for women themselves and their fetuses. Nearly half a billion globally and around one-third in Ethiopia of pregnant women were affected by anemia which has both health and economic impact. Therefore, this study aimed to identify the determinants of anemia among pregnant women attending antenatal care at public hospitals in the West Shewa zone, Oromia regional state, Central Ethiopia, 2019. Methods. An unmatched case-control study was conducted at public hospitals in the West Shewa zone, Ethiopia, from February to April 2019. A consecutive sampling was used to select study participants. Data were collected by a structured questionnaire, and the collected data were entered into Epi Info version 7 and SPSS version 23 for analyses. Descriptive statistics such as tables, graphs, and proportions were used to present the data. Binary and multiple logistic regression analyses were computed to identify the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value <0.05 were used to determine the presence of an association. Result. A total of 426 women (142 cases and 284 controls) participated in this study with a 95.3% response rate. Family size >5 (AOR = 2.95, 95% CI: 1.34–6.50), peptic ulcer diseases (PUD) (AOR = 2.85, 95% CI: 1.14–7.13), having the previous history of abortion (AOR = 2.84, 95% CI: 1.08–7.47), birth interval <2 years (AOR = 2.61, 95% CI: 1.20–5.70), antepartum hemorrhage (APH) (AOR = 6.05, 95% CI: 1.95–18.81), and not using latrine (AOR = 3.45, 95% CI: 1.30–9.24) were the identified determinants of anemia. Conclusions. Family size, PUD, abortion, birth interval, APH, and unable to use latrine were the determinants of anemia among pregnant women. Therefore, the intervention on anemia prevention should consider the promotion of family planning methods and counseling on latrine utilization.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110261
Author(s):  
Gizachew Abdissa Bulto ◽  
Daniel Belema Fekene ◽  
Benyam Seifu Woldeyes ◽  
Bikila Tefera Debelo

Background. Neonatal sepsis is the cause of substantial morbidity and mortality, mostly affecting the developing countries including Ethiopia. Previously conducted studies also highlighted the high prevalence of neonatal sepsis in Ethiopia. Therefore, this study was aimed at assessing the determinants of neonatal sepsis in the central Ethiopia. Method. Institution based un-matched case control study was conducted among 192 cases (neonates with sepsis) and 384 controls (without sepsis) in public hospitals in Central Ethiopia. The data were collected through face-to-face interview using structured questionnaire and extraction from maternal and neonatal charts. Binary logistic regression (bi-variable and multi-variable) model was fitted. Adjusted odds ratio with respect to 95% confidence interval was employed for the strength and directions of the association. Results. Younger maternal-age; 30 to 34 years (AOR = 0.41, 95%CI: 0.19-0.85) and 25 to 29 years (AOR = 0.38, 95%CI: 0.17-0.84), not having antenatal care (ANC) follow-ups (AOR = 1.89, 95%CI: 1.02-3.49), place of delivery; home (AOR = 12.6, 95%CI: 5.32-29.82) and health center (AOR = 2.74, 95%CI: 1.7, 4.41), prolonged duration of labor (AOR = 1.90, 95%CI: 1.22, 2.96), prolonged rupture of membrane 12 to 17 hours (AOR = 3.26, 95%CI: 1.46, 7.26) and ≥18 hours (AOR = 5.18, 95%CI: 1.98, 13.55) were maternal related determinants of neonatal sepsis. Whereas, prematurity (AOR = 2.74, 95%CI: 1.73, 4.36), being resuscitated (AOR = 1.93, 95%CI: 1.22, 3.06) and not having meconium aspiration syndrome (AOR = 2.55, 95%CI: 1.34, 4.83) were identified as neonatal related determinants of neonatal sepsis. Conclusion. Younger maternal age, not having antenatal care follow-up, home, and health center delivery, prolonged duration of labor, prolonged duration of rupture of membrane, prematurity, had resuscitation, and neonates without meconium aspiration syndrome were found to be determinants of neonatal sepsis. Therefore, the concerned stakeholders should consider those identified determinants during an intervention for improvement of neonatal health.


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