scholarly journals Risk factors associated with pre-term birth in Dar es Salaam, Tanzania: a case-control study

2015 ◽  
Vol 18 (1) ◽  
Author(s):  
Fanaka A. Mahapula ◽  
Kitindi Kumpuni ◽  
Joyce P. Mlay ◽  
Theresia F. Mrema

Background: Preterm birth remains one of the most serious problems in obstetrics care. Its aetiology is complex and multifactorial. This study was carried out to determine risk factors for preterm birth in Dar es Salaam City in Tanzania.Methods: This case-control study was conducted in three municipal hospitals namely, Amani, Mwananyamala and Temeke in Dar es Salaam. It involved 377 pairs of women with preterm birth (cases) and term birth (controls). Eligible women who agreed to participate and who signed the consent form completed a short interview regarding demographic and lifestyle factors, had their baby examined for maturity, and had their medical records abstracted. All cases and controls were interviewed face-to-face using a specially designed questionnaire. Multivariate logistic regression after controlling for potential confounders was used to measure the strength of associations between preterm birth and related factors.Results: Several significant risk factors associations with pre-term birth were multiple pregnancies (AOR = 8.6; 95%CI 4.5-16.5; p-value <0.001), untreated vaginal discharge (AOR = 5.2; 95%CI 1.1-24.4; p-value 0.034), public prenatal care (AOR = 2.1; 95%CI 1.1-4.1; p-value 0.017), untreated urinary tract infection (AOR = 2.7; 95%CI 1.2-6.1; p-value 0.016), complication during pregnancy (AOR = 2.7; 95%CI 1.3-5.3; p-value 0.004), cervical incompetence (AOR = 11.6; 95%CI 1.1-121.5; p-value 0.04), polyhydramnios (AOR = 8.3; 95%CI 1.7-40.2; p-value 0.008), and lack of antenatal visits  (AOR = 5.1; 95%CI 1.4-17.8; p-value 0.042).Conclusion: This study has identified several risk factors for preterm birth in the city of Dar es Salaam. It is important that planners design community-based interventions to address complications from preterm birth.

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.


Author(s):  
Niaz Mustafa Kamal ◽  
Nasih Othman

Congenital anomalies comprise a wide range of abnormalities in body structure or function that are present at birth and are of prenatal origin. These are defined as structural changes that have significant medical, social or cosmetic consequences for the affected individual, and typically require medical intervention. According to our Knowledge, research is scarce on these conditions in Sulaimaniyah city. Therefore, the current study was conducted to investigate potential risk factors for congenital anomalies. A case-control study was carried out from March to August 2017 involving 400 children (200 cases and 200 controls) aged 0-5 years. Required data were obtained on the risk factors through face to face interviews with mothers of cases and controls. The data were using descriptive statistical methods, Chi-square and Logistic Regression using STATA 11, calculating odds ratios and condensing P value less than 0.05 as statistically significant. The mean age of the children was 1.9 years and age of their mothers at the time of pregnancy was 28 years. Congenital heart anomalies were the commonest type accounting for 27.5%. Significant risk factors for congenital anomalies were family history (OR=2.24, P= 0.007), maternal obesity (OR= 2.26, P= 0.001), mothers age over 30 (OR=2.78, P= 0.002) and mothers not using folic acid during pregnancy (OR=2.12, P= 0.0007). In general, in order to control and prevent the cases of CM, it is important to provide health education and policies to reduce environmental and maternal risk factors. Further, studies with larger sample size are needed to investigate incidence and risk factors of congenital anomalies.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Arisara Poosari ◽  
Thitima Nutravong ◽  
Prakasit Sa-ngiamwibool ◽  
Wises Namwat ◽  
Supaporn Chatrchaiwiwatana ◽  
...  

Abstract Background Previous studies have shown the association between Campylobacter species infection and that environmental factors, poor oral hygiene in particular, are linked to an increased risk of esophageal cancer (EC). However, no study has reported on these factors in Thailand. Thus, this study’s objective was to evaluate the impact of the relationship between Campylobacter infection and environmental factors on EC incidence in the population of Thailand. Methods Data from a case–control study were collected from 105 newly diagnosed EC cases and 105 controls recruited from 2007 to 2017. Infection with Campylobacter spp. was detected in the formalin-fixed paraffin-embedded (FFPE) tissue of EC taken from gastroesophageal biopsy specimens obtained from the participants, and evaluated using TaqMan® real-time PCR. Multivariable logistic regression was performed to calculate the odds ratios (ORs) and perform data analysis. Results Smoking, alcohol use, a family history of cancer, history of gastroesophageal reflux disease, poor oral hygiene and Campylobacter spp. infection were shown to be significant risk factors for EC (p  <  0.05). The combination of poor oral hygiene and infection with Campylobacter spp. constituted significant risk for EC (p  <  0.001). In addition, the risk of EC in subjects co-infected with C. rectus and C. concisus that practiced poor oral hygiene was even higher and was significant (ORadj  =  4.7; 95% CI 2.41–9.98; p  =  0.003). Conclusions In Thailand, the major risk factors for EC are smoking status, alcohol drinking, family history of cancer, GERD, poor oral hygiene and Campylobacter spp. infection. This study found Campylobacter spp. prevalence to be associated with EC and appears to be enhanced by poor oral hygiene, suggesting that a combination of poor oral hygiene and Campylobacter species infection may together act as an important etiological risk factor for EC.


Author(s):  
Mayadevi Brahmanandan ◽  
Lekshmi Murukesan ◽  
Bindu Nambisan ◽  
Shaila Salmabeevi

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.


2020 ◽  
Author(s):  
Marcus Valerius da Silva Peixoto ◽  
Andrezza Marques Duque ◽  
Allan Dantas dos Santos ◽  
Shirley Verônica Melo Almeida Lima ◽  
Caíque Jordan Nunes Ribeiro ◽  
...  

ABSTRACTBackgroundCerebral palsy is the main cause of physical disability in childhood.ObjectivesThis study analyzed prenatal and perinatal risk factors that contribute to cerebral palsy in Brazilian children.MethodsA case-control study was conducted with 2- to 10-year-old children in the city of Aracaju, Sergipe, Brazil. The cases were population-based, selected from the Primary Health Care services. The controls were selected from the database of the Brazilian Live Births Information System. Controls were paired with cases by gender, year, and hospital of birth.ResultsA total of 570 participants (114 cases and 456 controls) were studied. Most of the participants were male, with bilateral spastic cerebral palsy. Among the prenatal factors examined, the presence of congenital anomalies was significantly different between cases and controls (OR = 54.28, [95% CI 12.55, 234.86]). The analysis of perinatal factors revealed significant differences between cases and controls in low birth weight (OR = 3.8, [95% CI 2.34, 6.16]), preterm birth (OR = 2.31, [95% CI 1.41, 3.80]), and low Apgar scores (OR = 14.73, [95% CI 5.27, 41.15]).ConclusionsThe main prenatal and perinatal factors associated with cerebral palsy in our population were congenital anomalies, low Apgar scores, low birth weight, and preterm birth. The perinatal period had more risk factors, demanding a deeper study of their causes and of possible preventive measures.


2021 ◽  
Vol 8 (6) ◽  
pp. 67-73
Author(s):  
Obetta Hillary Ikechukwu ◽  
Babagana Bako ◽  
Nweze Sylvester Onuegunam

Background: Preterm birth (PTB) is an important cause of perinatal morbidity and mortality in developing societies like Nigeria. It poses huge long-term medical and financial burdens for the affected children, their families, the health care system and society at large. Objective: The objective of this study was to determine the prevalence, risk factors and birth outcome of PTB at UMTH, Nigeria. Methodology: A two-year case-control study of cases of preterm births at the UMTH, from 1st January, 2016 to 31st December, 2017 was undertaken. For each PTB, the next term delivery was taken as control. Information on socio-demographic characteristics, risk factors, gestational ages at presentation and delivery, and birth outcome were obtained from the women’s case files with proforma and compared with that of the control. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software Version 23. The statistical significance was set at P<0.05. Results: During the period under review, there were 6,171 deliveries and preterm births constituted 291 births giving a prevalence rate of 4.7% or 47 per 1000 deliveries. The mean ages for the cases and controls were similar 26.4± 6.1 vs 26.5± 5.3 with (F=0.15, P=0.7) while the mean parity were 3.0±2.6 and 3.2±2.5 with (F=4.6, P=0.03). Nulliparity was commoner among the cases 61(24.6%) compared to the controls 34(13..7%) with X2 = 9.69, P=0.001. Similarly, 96(38.7%) of the cases were unbooked compared to 44(17.7%) among the conrols X2 = 26.9, P=0.000. About 20% of the cases had no formal education compared to 13% of the control. Preterm birth was associated with unbooking status (OR=1.82, CI: 1.40-2.36), nulliparity (OR = 2.05, CI: 1.29-3.26), previous preterm delivery (OR = 95.2, CI: 13.10-691.99) and pregnancy induced hypertension (OR = 25.45, CI: 9.13-70.92). Antepartum haemorrhage (OR = 13.89, CI: 4.92-39.25), twin gestation (OR = 18.18, CI: 2.40-137.68), Polyhydramnios (OR = 2.02, CI: 1.85-2.22) and PROM (OR = 5.39, CI: 2.87-10.15) were other risk factors independently associated with PTB. The perinatal mortality in PTB was 43(16.2%). Conclusion: The prevalence rate of PTB at the UMTH is 4.7% and is associated with previous PTB, unbooked status, twin gestation, polyhydramnious, APH and PIH. Efforts should be intensified on educating women of reproductive age group on the benefits of antenatal booking in pregnancy and quality antenatal care as this would provide ample opportunity for early detection and proper management of women at risk. Keywords: Preterm birth, Risk factors, Neonatal outcome, Maiduguri.


2021 ◽  
Vol 8 (13) ◽  
pp. 806-810
Author(s):  
Asha P.S ◽  
Sujatha T.L.

BACKGROUND Meconium stained amniotic fluid is a significant contributor to perinatal and neonatal morbidity and mortality. The study was conducted to determine the risk factors of meconium stained amniotic fluid in term pregnancy. METHODS This study is a prospective case control study done in a tertiary care hospital in South India over a period of one year. 100 women with meconium stained amniotic fluid detected at any time during the course of labour, prior to it or meconium detected in hind waters were enrolled in the study group. The inclusion criteria were term pregnancy, cephalic presentation and singleton pregnancy. 200 women who satisfied the same set of inclusion criteria with clear amniotic fluid, selected on random basis were taken as controls. A standardised pretested proforma was used for data collection. RESULTS In the study, incidence of grade 1, grade 2 and grade 3 meconium were 31 %, 42 % and 27 % respectively. 83 % of cases were in the 20 – 24 year age group and advanced maternal age was not a risk factor in the study. Primiparity (86 % cases vs. 47 % controls) and advanced gestational age (56 % cases and 33 % controls) were significant risk factors. Maternal obesity, socioeconomic status and treatment for infertility were not significant risk factors. Among medical disorders, gestational diabetes mellitus (21 % cases vs. 5 % controls), gestational hypertension (12 % vs. 3.5 %) and hypothyroidism (13 % cases vs. 4.5 % controls) showed statistical significance. Oligoamnios (9 % vs. 1 %), fetal growth restriction (13 % vs. 4.5 %) and maternal infection (12 % vs. 2 %) were significant risk factors. Induced labour and prolonged labour were the significant intrapartum risk factors. Caesarean section rates were nearly doubled in cases (40 %) compared to controls (21.5 %). Babies born to mothers with meconium stained amniotic fluid had low Apgar scores at birth (25 %) and increased neonatal intensive care unit (NICU) admission. CONCLUSIONS Meconium stained amniotic fluid is associated with increased rates of maternal morbidity due to higher rates of operative deliveries and increased incidence of perinatal asphyxia, perinatal morbidity and mortality. Meticulous antenatal care and early identification of risk factors help in reducing the incidence of meconium stained amniotic fluid and preventing adverse maternal and neonatal outcome. KEYWORDS Risk Factors, Meconium, Amniotic Fluid, Term Pregnancy, Caesarean Section, Perinatal Outcome


2020 ◽  
Author(s):  
Siros Hemmatpour ◽  
Majid Mansori ◽  
Ghobad Moradi ◽  
Shobo Sheikhahmadi ◽  
Batool Bagheri

Abstract Background Preterm birth is one of the most common causes of mortality in infants. Despite advances in health care and better access to health services in many countries, preterm birth has increased over the past two decades. Methods This case control study was conducted on two groups with 100 participants including 100 preterm infants (case) and 100 term infants (control) with gender match in Kurdistan Province-Iran in 2018. The required information was collected from medical files and interviewing the mothers as to demographical information, midwifery specifications, background diseases, disease over pregnancy term, and infants’ information. Conditional logistic regression test was used to estimate the final model and compute the risk ratio. Results Multivariate regression analysis showed that the risk of preterm birth in individual with AB blood type was higher (OR=5.04; 95% CI 1.40-18.08). In addition, the risk of preterm birth was higher in the mothers with a history of stillbirth (OR=13.63; 95% CI 1.39-133.5). Preterm birth was significantly related to the history of birth diseases, history of pregnancy diseases, and using medicine for specific diseases during pregnancy. Conclusions Blood type of mother, history of still birth, history of birth disease, history of pregnancy diseases, using medicines for specific diseases, and history of preterm birth were the risk factors of preterm birth. These factors need to be taken into account before and during pregnancy. Paying more attention to these factors attenuates the rate of preterm birth and premature infants and in turn the mortality rate of infants and mothers.


2021 ◽  
Author(s):  
marianna meschiari ◽  
Shaniko Kaleci ◽  
Gabriella Orlando ◽  
Silvia Selmi ◽  
Antonella Santoro ◽  
...  

Abstract Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case-control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR: 10.15, 95%CI: 2.27–45.39; P = 0.002), mechanical ventilation (OR: 40.01, 95%CI: 4.05–395.1; P = 0.002), urinary catheters (OR: 4.9, 95%CI:1.52–16.19; P = 0.008), McCabe score (OR: 5.45, 95%CI: 1.87–15.89; P = 0.002), length of stay (OR: 1.03, 95%CI: 1.01–1.05; P = 0.002), carbapenem use (OR: 5.39, 95%CI: 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.


2018 ◽  
Vol 57 (6) ◽  
pp. 814-818 ◽  
Author(s):  
Min Jiang ◽  
Miskatul Mustafa Mishu ◽  
Dan Lu ◽  
Xianghua Yin

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