1
|
Jerbi B, Chourou H, Ben Aziza R, Belhadj Ammar W, Kacem S, Achour R. Early Challenges: A Case Report of a Premature Baby with Down Syndrome and Uterine Rupture. AJP Rep 2024; 14:e231-e234. [PMID: 39351245 PMCID: PMC11442015 DOI: 10.1055/a-2413-2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 08/20/2024] [Indexed: 10/04/2024] Open
Abstract
Introduction Uterine rupture represents one of the most severe obstetric affections. It is defined as a complete or a partial tearing of the uterine wall. Women with a prior cesarean section are reported to have a higher risk of having this situation. Moreover, maternal death and most of all middle- and long-term adverse consequences remain a great preoccupation. On another scale, neonatal death and ulterior deterioration remain very high, especially in low-income countries. Case Description A 24-year-old woman with a history of previous cesarean section presented at 35 weeks of gestation with pelvic pain without bleeding. Emergency cesarean section revealed a complete uterine rupture at the scar site from the previous cesarean section. Remarkably, the fetus managed to seal the rupture using the right temporal region, forearm, and right leg, avoiding significant complications. The mother had an uncomplicated postoperative course and was discharged after 48 hours of surveillance. Conclusion We present with this case an extraordinary case of a uterine rupture where both mother and child had a good outcome. This rare evolution was reported only one time in literature. For this reason, a history of caesarean delivery might present a huge challenge for obstetricians and neonates.
Collapse
Affiliation(s)
- Bilel Jerbi
- Department of Community Medicine A, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Hajer Chourou
- Neonatal Intensive Care Unit, Center of Maternity and Neonatology of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Rim Ben Aziza
- Neonatal Intensive Care Unit, Center of Maternity and Neonatology of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Wafa Belhadj Ammar
- Neonatal Intensive Care Unit, Center of Maternity and Neonatology of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Samia Kacem
- Neonatal Intensive Care Unit, Center of Maternity and Neonatology of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Radhouane Achour
- Department of Emergency, Center of Maternity and Neonatology of Tunis, University Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
2
|
Zewde HK. Determinants of severe maternal outcome in Keren hospital, Eritrea: An unmatched case-control study. PLoS One 2024; 19:e0299663. [PMID: 38739618 PMCID: PMC11090357 DOI: 10.1371/journal.pone.0299663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/14/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND In the past few decades, several studies on the determinants and risk factors of severe maternal outcome (SMO) have been conducted in various developing countries. Even though the rate of maternal mortality in Eritrea is among the highest in the world, little is known regarding the determinants of SMO in the country. Thus, the aim of this study was to identify determinants of SMO among women admitted to Keren Provincial Referral Hospital. METHODS A facility based unmatched case-control study was conducted in Keren Hospital. Women who encountered SMO event from January 2018 to December 2020 were identified retrospectively from medical records using the sub-Saharan Africa maternal near miss (MNM) data abstraction tool. For each case of SMO, two women with obstetric complication who failed to meet the sub-Saharan MNM criteria were included as controls. Bivariate and multivariate logistic regression analyses were employed using SPSS version-22 to identify factors associated with SMO. RESULTS In this study, 701 cases of SMO and 1,402 controls were included. The following factors were independently associated with SMO: not attending ANC follow up (AOR: 4.53; CI: 3.15-6.53), caesarean section in the current pregnancy (AOR: 3.75; CI: 2.69-5.24), referral from lower level facilities (AOR: 11.8; CI: 9.1-15.32), residing more than 30 kilometers away from the hospital (AOR: 2.97; CI: 2.29-3.85), history of anemia (AOR: 2.36; CI: 1.83-3.03), and previous caesarean section (AOR: 3.49; CI: 2.17-5.62). CONCLUSION In this study, lack of ANC follow up, caesarean section in the current pregnancy, referral from lower facilities, distance from nearest health facility, history of anaemia and previous caesarean section were associated with SMO. Thus, improved transportation facilities, robust referral protocol and equitable distribution of emergency facilities can play vital role in reducing SMO in the hospital.
Collapse
Affiliation(s)
- Henos Kiflom Zewde
- Departement of Family and Community Health, Ministry of Health Anseba Province, Keren, Anseba, Eritrea
| |
Collapse
|
3
|
Sugai S, Yamawaki K, Haino K, Yoshihara K, Nishijima K. Incidence of Recurrent Uterine Rupture: A Systematic Review and Meta-analysis. Obstet Gynecol 2023; 142:1365-1372. [PMID: 37884008 PMCID: PMC10642701 DOI: 10.1097/aog.0000000000005418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/31/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE We aimed to quantify the incidence of recurrent uterine rupture in pregnant women. DATA SOURCES A literature search of PubMed, Web of Science, Cochrane Central, and ClinicalTrials.gov for observational studies was performed from 2000 to 2023. METHODS OF STUDY SELECTION Of the 7,440 articles screened, 13 studies were included in the final review. We included studies of previous uterine ruptures that were complete uterine ruptures , defined as destruction of all uterine layers, including the serosa. The primary outcome was the pooled incidence of recurrent uterine rupture. Between-study heterogeneity was assessed with the I2 value. Subgroup analyses were conducted in terms of the country development status, year of publication, and study size (single center vs national study). The secondary outcomes comprised the following: 1) mean gestational age at which recurrent rupture occurred, 2) mean gestational age at which delivery occurred without recurrent rupture, and 3) perinatal complications (blood loss, transfusion, maternal mortality, and neonatal mortality). TABULATION, INTEGRATION, AND RESULTS A random-effects model was used to pool the incidence or mean value and the corresponding 95% CI with R software. The pooled incidence of recurrent uterine rupture was 10% (95% CI 6-17%). Developed countries had a significantly lower uterine rupture recurrence rate than less developed countries (6% vs 15%, P =.04). Year of publication and study size were not significantly associated with recurrent uterine rupture. The mean number of gestational weeks at the time of recurrent uterine rupture was 32.49 (95% CI 29.90-35.08). The mean number of gestational weeks at the time of delivery without recurrent uterine rupture was 35.77 (95% CI 34.95-36.60). The maternal mortality rate was 5% (95% CI 2-11%), and the neonatal mortality rate was 5% (95% CI 3-10%). Morbidity from hemorrhage, such as bleeding and transfusion, was not reported in any study and could not be evaluated. CONCLUSION This systematic review estimated a 10% incidence of recurrent uterine rupture. This finding will enable appropriate risk counseling in patients with prior uterine rupture. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42023395010.
Collapse
Affiliation(s)
- Shunya Sugai
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | | | | | | | | |
Collapse
|
4
|
Oljira L, Abdissa E, Lema M, Merdassa E, Wakoya Feyisa J, Desalegn M. Antenatal depression and associated factors among pregnant women attending antenatal care at public health facilities in the Gida Ayana district, Oromia Region, West Ethiopia, in 2022. Front Public Health 2023; 11:1176703. [PMID: 37876710 PMCID: PMC10591076 DOI: 10.3389/fpubh.2023.1176703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023] Open
Abstract
Background Though antenatal depression (AND) has a risk of maternal and fetal morbidity and mortality, it is a neglected component of pregnancy care in Ethiopia. Research evidence is compulsory in different parts of the country to alleviate this problem. Thus, this study was needed to assess antenatal depression and its associated factors, which can help antenatal care (ANC) providers and program coordinators focus on the mental health of pregnant mothers. Objectives This study aimed to assess antenatal depression and associated factors among pregnant women attending ANC at public health facilities in the Gida Ayana district, Oromia Region, West Ethiopia, in 2022. Methods A facility-based cross-sectional study was conducted among 370 pregnant women attending ANC at public health facilities. Systematic random sampling techniques were used to select study participants. A standard (validated) tool, the Edinburgh Postnatal Depression Scale, was also used to assess antenatal depression. The collected data were coded, entered into Epi-data software version 4.6, and analyzed by SPSS version 23. Multivariable logistic regression analyses were used to identify associated factors with a p-value <0.05. Results In this study, the prevalence of antenatal depression was 62 (16.8%; 95% CI: 13, 20.5). Being single in marital status (AOR = 3, 95% CI: 1.5, 6.2), having an unplanned pregnancy (AOR = 2.7, 95% CI: 1.45, 5.1), and having partner conflict (AOR = 3.49, 95% CI: 1.79, 6.8) were the factors associated with antenatal depression. Conclusion About one in five pregnant women has antenatal depression. Being single, having an unplanned pregnancy, and having a dissatisfied relationship with a sexual partner were the factors associated with antenatal depression. Therefore, women or partners are expected to plan pregnancy, and the dissemination of health information related to an unplanned pregnancy needs to be intensified by health providers. The partner ought to avoid conflict during the pregnancy, and healthcare providers or families are needed to support the single or widowed pregnant women. Further prospective cohort studies are needed to ascertain the effect of antenatal depression on fetal-maternal outcomes.
Collapse
Affiliation(s)
- Lelisa Oljira
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Eba Abdissa
- Department of Psychiatry Nursing, School of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Matiyos Lema
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Emiru Merdassa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Jira Wakoya Feyisa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Markos Desalegn
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| |
Collapse
|
5
|
Huyghe S, Telo S, Danwesse E, Ali E, van den Boogaard W, Lagrou D, Caluwaerts S, Ngbalé RN. Mise à jour thérapeutique et pronostique de la rupture utérine dans une maternité à Bangui, CAR. Public Health Action 2023; 13:13-18. [PMID: 37529553 PMCID: PMC10380413 DOI: 10.5588/pha.23.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/12/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Maternal mortality rates remain high (882/100,000 births) in the Central African Republic (CAR), primarily due to frequent obstetric complications. Médecins Sans Frontières supports a referral maternity ward in the capital, Bangui. OBJECTIVES To describe the prevalence, associated factors and fatality of one of the most severe complications, uterine rupture, as well as the effect of a history of uterine surgery. METHODS This is a cross-sectional study based on retrospectively collected data between January 2018 and December 2021 for women who delivered new-borns weighing over 1,000 g. RESULTS Of 38,782 deliveries, 229 (0.6%) cases of uterine rupture were recorded. Factors associated with uterine rupture were parity ⩾5 (adjusted odds ratio [aOR] 7.5, 95% confidence interval [CI] 4.6-12.2), non-occipital foetal presentation (aOR 2.8, 95% CI 2.1-3.7) and macrosomia (OR 4, 95% CI 2.6-6.4). The fatality rate was 4.4%, and the stillbirth rate was 64%. Uterine rupture occurred in non-scarred uterus in 150 (66.1%) women. Adverse outcomes were more common in cases of uterine rupture on non-scarred uterus compared to scarred uterus, with higher maternal mortality (6% vs. 0%, P = 0.023) and lower Apgar scores (<2) for new-borns (69.1% vs. 45.8%, P < 0.001). CONCLUSION Uterine rupture remains a major issue for maternal and perinatal health in the CAR, and efforts are needed to early detect risk factors and increase coverage of the comprehensive emergency obstetric and neonatal care.
Collapse
Affiliation(s)
- S Huyghe
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine
| | - S Telo
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine
| | - E Danwesse
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine
| | - E Ali
- Ministère de la Santé, Direction de la Santé, Luxembourg, Luxembourg
| | - W van den Boogaard
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Luxembourg Operational Research Unit (LuxOR), Luxembourg, Luxembourg
| | - D Lagrou
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Département Médical, Bruxelles, Belgique
| | - S Caluwaerts
- Médecins Sans Frontières Centre Opérationnel de Bruxelles, Département Médical, Bruxelles, Belgique
| | - R N Ngbalé
- Centre Hospitalier Universitaire Communautaire, Bangui, République Centrafricaine
| |
Collapse
|
6
|
Tesfay N, Hailu G, Woldeyohannes F. Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Front Pediatr 2023; 11:1120979. [PMID: 36824654 PMCID: PMC9941639 DOI: 10.3389/fped.2023.1120979] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Receiving at least four antenatal care (ANC) visits have paramount importance on the health of mothers and perinates. In Ethiopia, several studies were conducted on ANC service utilization; however, limited studies quantified the effect of care on maternal and perinate health. In response to this gap, this study is conducted to quantify the effect of optimal ANC care (≥4 visits) on maternal and perinatal health among women who received optimal care in comparison to women who did not receive optimal care. METHODS The study utilized the Ethiopian perinatal death surveillance and response (PDSR) system dataset. A total of 3,814 reviewed perinatal deaths were included in the study. Considering the nature of the data, preferential within propensity score matching (PWPSM) was performed to determine the effect of optimal ANC care on maternal and perinatal health. The effect of optimal care was reported using average treatment effects of the treated [ATT]. RESULT The result revealed that optimal ANC care had a positive effect on reducing perinatal death, due to respiratory and cardiovascular disorders, [ATT = -0.015, 95%CI (-0.029 to -0.001)] and extending intrauterine life by one week [ATT = 1.277, 95%CI: (0.563-1.991)]. While it's effect on maternal health includes, avoiding the risk of having uterine rupture [ATT = -0.012, 95%CI: (-0.018 to -0.005)], improving the utilization of operative vaginal delivery (OVD) [ATT = 0.032, 95%CI: (0.001-0.062)] and avoiding delay to decide to seek care [ATT = -0.187, 95%CI: (-0.354 to -0.021)]. CONCLUSION Obtaining optimal ANC care has a positive effect on both maternal and perinatal health. Therefore, policies and interventions geared towards improving the coverage and quality of ANC services should be the top priority to maximize the benefit of the care.
Collapse
Affiliation(s)
- Neamin Tesfay
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Girmay Hailu
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fitsum Woldeyohannes
- Health Financing Department, Clinton Health Access Initiative, Addis Ababa, Ethiopia
| |
Collapse
|
7
|
Namagembe I, Chukwuma SM, Nakimuli A, Kiwanuka N, Byamugisha J, Moffett A, Aiken CE. Learning from maternal deaths due to uterine rupture: review of cases from peri-urban Uganda. AJOG GLOBAL REPORTS 2022; 2:100063. [PMID: 36276797 PMCID: PMC9563662 DOI: 10.1016/j.xagr.2022.100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Maternal deaths from uterine rupture continue to occur globally, with particularly high rates in sub-Saharan Africa. Maternal death reviews have been shown to be an effective part of cohesive strategies to prevent future deaths. OBJECTIVE This study aimed to conduct maternal death reviews for all deaths following uterine rupture in the study center, to assess preventability, and to synthesize key learning points that may help to prevent future maternal deaths following uterine rupture. STUDY DESIGN Thorough case reviews of all maternal deaths from 2016 to 2018 at the study center (a national referral hospital in urban Uganda) were conducted by trained multidisciplinary panels of obstetricians and midwives. Medical records of women who died following uterine rupture (n=37, 10.6% of all maternal deaths) were extracted for further analysis. RESULTS Most maternal deaths due to uterine rupture (36/37, 97%) were preventable, with most having been still potentially preventable after the women reached the study center (24/36, 67%). Obstructed labor was the leading cause of uterine rupture, accounting for 73% (27/37) of cases. Previous cesarean delivery was confirmed in 38% (14/37) of cases. The incidence of grand multiparity was 11% (4/37), and 11% (4/37) were primiparous. Most women (28/37, 76%) died within 24 hours of admission. On arrival at the study center, 19 (51%) were critically ill. Exploratory laparotomy was performed in 54% (20/37) of cases, and a further 35% (13/37) died while awaiting laparotomy. Four women died shortly after arrival at the study center (within 1 hour) and received basic resuscitative treatment; 27% (10/37) of women who died had received antenatal planning or preparation. CONCLUSION Most deaths due to uterine rupture were preventable. The key lessons that emerged from the reviews were: (1) careful birth preparation and complication awareness for women with known risk factors, (2) early recognition of obstructed labor, (3) close monitoring of obstetrical interventions known to be associated with uterine rupture, and (4) treating incipient or suspected uterine rupture as a time-critical obstetrical emergency. The recommendations emerging from our narrative reviews are suitable for implementation in low-resource obstetrical settings, where high numbers of deaths involving uterine rupture occur.
Collapse
Affiliation(s)
- Imelda Namagembe
- Department of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda (Drs Namagembe, Nakimuli, and Byamugisha)
| | - Sarah M Chukwuma
- Department of Obstetrics and Gynaecology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom (Ms Chukwuma)
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda (Drs Namagembe, Nakimuli, and Byamugisha)
| | - Noah Kiwanuka
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda (Dr Kiwanuka)
| | - Josaphat Byamugisha
- Department of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda (Drs Namagembe, Nakimuli, and Byamugisha)
| | - Ashley Moffett
- Department of Pathology and Centre for Trophoblast Research, University of Cambridge, Cambridge, United Kingdom (Dr Moffett)
| | - Catherine E Aiken
- Department of Obstetrics and Gynaecology, University of Cambridge, Rosie Hospital and National Institute for Health and Care Research Cambridge Biomedical Research Center, Cambridge, United Kingdom (Dr Aiken)
| |
Collapse
|
8
|
Abrar S, Abrar T, Sayyed E, Naqvi SA. Ruptured uterus: Frequency, risk factors and feto-maternal outcome: Current scenario in a low-resource setup. PLoS One 2022; 17:e0266062. [PMID: 35395033 PMCID: PMC8993016 DOI: 10.1371/journal.pone.0266062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Pakistan is among the countries with the highest maternal death rates. Obstetric hemorrhage accounts for 41% of these deaths. Uterine rupture is a grave obstetric emergency with high maternal and neonatal morbidity and mortality. It is important to identify its frequency and associated risk factors to formulate programs for its prevention and management. This study aimed to assess the frequency, associated risk factors, fetomaternal outcomes, and management of women with the ruptured uterus at our hospital. MATERIAL AND METHODS It was a retrospective study of 206 women to review data collected from cases of uterine rupture managed at the WCTH Bannu, Pakistan from October 2016 to October 2018. A structured proforma was designed and used to extract data from operating theatre registers and the hospital medical records. In our hospital, there is a strong system of maintaining all information of the patients related to demographics, obstetric information, operative notes, and postoperative course during their hospital stay in the patient's charts. Detailed information on operative procedures is further maintained in the operation theater register and all these registers are checked in the weekly statistical meetings to ensure proper documentation. Data was entered and analyzed in SPSS package version 21 (IBM Corp.; Armonk, NY, USA). Frequency and percentages were calculated for the categorical variables. For inferential statistics, chi-square or Fischer exact tests were used. A p-value of < 0.05 was considered statistically significant. RESULTS The overall incidence of the ruptured uterus was 1.71%. The important etiological factors were grand multiparity 62 (35.2%), obstructed/neglected labour 58 (32.9%), injudicious use of Oxytocin 56 (31.8%) and prostaglandins 26 (14.7%), previous cesarean section 35 (19.8%) and previous pelvic surgery (0.5%). Hysterectomy was done in 80.6% of cases, 34 (19.2%) patients underwent uterine repair and 4.5% had bladder repair. The mortality rate was 21%, mainly due to irreversible shock or disseminated intravascular coagulation. Perinatal mortality was 91.4%. Duration of surgery more than two hours and presentation to the hospital at night time was significantly associated with poor maternal outcome (p = 0.00). CONCLUSION Uterine rupture is a preventable obstetric emergency associated with high fetomaternal morbidity and mortality. The main causes were grand multigravidity, obstructed labour, previous C-sections and injudicious use of oxytocin and prostaglandins. Women with prolonged surgery and admission at night time had a poor maternal outcome.
Collapse
Affiliation(s)
- Saida Abrar
- Department of Gynecology and Obstetrics, Lady Reading Hospital, Khyber Medical College, Peshawar, Pakistan
| | - Tahira Abrar
- Department of Gynecology and Obstetrics, Lady Reading Hospital, Khyber Medical College, Peshawar, Pakistan
| | | | - Sidra Ali Naqvi
- Department of Pain Clinic, Shifa International Hospital, Islamabad, Pakistan
| |
Collapse
|
9
|
Bruno SKB, Rocha HAL, Rocha SGMO, Araújo DABS, Campos JS, Silva ACE, Correia LL. Prevalence, socioeconomic factors and obstetric outcomes associated with adolescent motherhood in Ceará, Brazil: a population-based study. BMC Pregnancy Childbirth 2021; 21:616. [PMID: 34496791 PMCID: PMC8427858 DOI: 10.1186/s12884-021-04088-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent motherhood (AM) remains a public health problem, especially in low and middle income countries, where approximately 95% of these births occur. Evidence from studies with population representativeness about events associated with AM is limited. We assessed the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes. METHODS A population-based cross-sectional study on maternal and child health of women aged 10 to 49 years, living in the state of Ceará, in northeastern Brazil was carried out to assess the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes. The definition of adolescence used in the study was the one utilized by the WHO. In addition to the interview, data were double-checked according to the information in the government's pregnancy health booklet. Sample-adjusted logistic models to determine the association of socioeconomic factors and AM, as well as the association of AM with obstetric outcomes, with a causal approach to multivariate analyses, were used. RESULTS The prevalence of adolescent motherhood was 18.6%. Poverty and household crowding were associated with greater chances of AM (p values of 0.038 and < 0.001, respectively), as well as not being in a stable relationship (OR 2.26 (95%CI: 1.67, 3.07), p < 0.001). AM showed a greater chance of not using community health services (p < 0.001), had fewer prenatal consultations (β - 0.432 (95%CI: - 0.75, - 0.10)) and started prenatal care at a later date (β 0.38 (95%CI: 0.21, 0.55), p < 0.001)). AM are also less likely to be tested for HIV and more likely to have urinary tract infections. CONCLUSIONS Interventions aimed at socially-vulnerable adolescents are suggested. However, if pregnant, adolescents should receive proactive and differentiated prenatal care.
Collapse
Affiliation(s)
| | - Hermano Alexandre Lima Rocha
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA. .,Department of Maternal and Child Health, Federal University of Ceará, Rua Professor Costa Mendes, 1608 5 Andar, Fortaleza, Ceará, Brasil CEP: 60430-140, Brazil.
| | | | | | | | | | - Luciano Lima Correia
- Department of Community Health, Federal University of Ceará, Fortaleza, CE, Brazil
| |
Collapse
|