Determinants of Stillbirth in Zambia

Stringer, Elizabeth M.; Vwalika, Bellington; Killam, William P.; Giganti, Mark J.; Mbewe, Reuben; Hanpin, Benjamin; Chintu, Namwinga; Rouse, Dwight J.; Goldenberg, Robert L.; Stringer, Jeffrey S. A.

doi:10.1097/aog.0b013e3182167627

Cited by 52 publications

(69 citation statements)

References 17 publications

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“…However, a prior publication found that women with delivery information in ZEPRS did not differ in any clinically significant way from women without delivery information. 36 Second, we do not have complete information available about laboratory malaria diagnosis, CTX prophylaxis, socioeconomic status, or HIV RNA viral load and were unable to adequately examine or control for these factors. Third, there are women in our study with more doses of SP than ANC visits.…”

Section: Discussionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Stoner

Vwalika

Smid

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In Lusaka, Zambia, where malaria prevalence is low, national guidelines continue to recommend that all pregnant women receive sulfadoxine-pyrimethamine (SP) for malaria prophylaxis monthly at every scheduled antenatal care visit after 16 weeks of gestation. Human immunodeficiency virus (HIV)-positive women should receive co-trimoxazole prophylaxis for HIV and not SP, but many still receive SP. We sought to determine whether increased dosage of SP is still associated with a reduced risk of low birth weight (LBW) in an area where malaria transmission is low. Our secondary objective was to determine whether any association between SP and LBW is modified by receipt of antiretroviral therapy (ART). We analyzed data routinely collected from a cohort of HIV-positive pregnant women with singleton births in Lusaka, Zambia, between February 2006 and December 2012. We used a logPoisson model to estimate the risk of LBW by dosage of SP and to determine whether the association between SP and LBW varied by receipt of ART. Risk of LBW declined as the number of doses increased and appeared lowest among women who received three doses (adjusted risk ratio [ARR] = 0.78; 95% confidence interval [CI] = 0.64-0.95). In addition, women receiving combination ART had a higher risk of delivering an LBW infant compared with women receiving no treatment or prophylaxis (ARR = 1.18; 95% CI = 1.09-1.28), but this risk was attenuated among women who were receiving SP (risk ratio = 1.09; 95% CI = 0.99-1.21). SP was associated with a reduced risk of LBW in HIVpositive women, including those receiving ART, in a low malaria prevalence region.

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Section: Discussionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Stoner

Vwalika

Smid

et al. 2017

The American Society of Tropical Medicine and Hygiene

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“…This finding reinforces the need of training of midwives in identification and proper referral of breech cases to proper facilities. Studies 23,24 have shown patients without antenatal care had two fold increased perinatal morbidity. Emergency caesarean sections were performed in 54 (35%) of patients selected for vaginal deliveries reasons being dysfunctional labour, fetal distress, footling breech & cord prolapse.…”

Section: Discussionmentioning

confidence: 99%

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Wasim

Wasim²,

Majrooh³

2017

Annals KEMU

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Objectives: To determine fetomaternal outcome in patients undergoing planned vaginal breech delivery at term. Methods:It was a descriptive cross sectional study conducted at Lady Aitchison hospital, Lahore for one and a half year from July 2012 to December 2013. All patients presenting with term breech presentation were included. Fetomaternal outcome in terms of successful vaginal delivery, maternal complications of operative delivery, PPH, wound infection and fetal complications of apgar score of less than five minutes, nursery admission, trauma during delivery (bone fracture, intra cranial hemorrhage) and perinatal mortality was studied.Results: 375 patients delivered as breech presentation during the study period. Out of 375 patients, 155 patients were selected for vaginal birth. Out of these, 65% had successful vaginal delivery, rest had emergency caesarean section due to fetal distress, cord prolapse, dysfunctional labour. 6.4% patients had wound infection and 3.2% had PPH. Booking status was significantly important in patients who had successful vaginal delivery as 80% were booked (p = 0.001). There was no maternal mortality in these patients. Perinatal outcome was good in 87% of patients. 20 fetuses had Apgar score less than 7/min and required nursery admission. Two babies expired due to birth asphyxia and rest were discharged home in satisfactory condition. Conclusion: Although delivery of breech remains a dilemma, the plan of delivery should be individualized. Proper selection of cases with proper antenatal and intrapartum care can result in successful breech vaginal delivery without compromising feto maternal wellbeing and curtailing the percentage of caesarean being done for this malpresentation.

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“…It is estimated that babies who die before the onset of labor, or ante partum stillbirths, account for two-thirds of all stillbirths in countries where the mortality rate is greater than 22 per 1,000 births [7]. From previous studies, preterm birth, increasing maternal age, history of stillbirth, reported hypertension, extremes of neonatal birth weight, cesarean delivery, operative vaginal delivery, and assisted breech delivery were all significantly associated with still birth [8]. According to Ethiopian Demographic and Health Survey in 2011, In Ethiopia, high rate of neonatal mortality (37 deaths per 1,000 live births)is reported and preterm birth is believe to be a major and direct cause of neonatal mortality [9].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Magnitude and Associated Factors of Adverse Birth Outcomes among Deliveries at Suhul Hospital Shire, Tigray, Ethiopia From September, 2015 to February, 2016

Haftu¹

2017

BJSTR

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Determinants of Stillbirth in Zambia

Abstract: Stillbirth is a major contributor to poor perinatal outcomes in Lusaka. Many deaths appear avoidable through investment in antenatal screening and better labor monitoring. Stillbirth should be adopted as a routine health indicator by the World Health Organization.

Cited by 52 publications

References 17 publications

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Assessment of Magnitude and Associated Factors of Adverse Birth Outcomes among Deliveries at Suhul Hospital Shire, Tigray, Ethiopia From September, 2015 to February, 2016

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