Does maternity care improve pregnancy outcomes in women with previous complications? A study from Zimbabwe

Majoko, Franz; Nyström, Lennarth; Munjanja, Stephen; Mason, Elizabeth; Lindmark, Gunilla

doi:10.1258/004947505774938710

Cited by 4 publications

(8 citation statements)

References 18 publications

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“…Cross-sectional studies in Africa have reported recurrence risks of preeclampsia and hypertension, ranging from15.8% to 36% [13,16]. The estimated recurrence risk of preeclampsia in our prospective study falls within this range.…”

Section: Discussionsupporting

confidence: 63%

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Recurrence of Preeclampsia in Northern Tanzania: A Registry-Based Cohort Study

et al. 2013

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ObjectivePreeclampsia occurs in about 4 per cent of pregnancies worldwide, and may have particularly serious consequences for women in Africa. Studies in western countries have shown that women with preeclampsia in one pregnancy have a substantially increased risk of preeclampsia in subsequent pregnancies. We estimate the recurrence risks of preeclampsia in data from Northern Tanzania.MethodsA prospective cohort study was designed using 19,811 women who delivered singleton infants at a hospital in Northern Tanzania between 2000and2008. A total of 3,909 women were recorded with subsequent deliveries in the hospital with follow up through 2010. Adjusted recurrence risks of preeclampsia were computed using regression models.ResultsThe absolute recurrence risk of preeclampsia was25%, which was 9.2-fold (95% CI: 6.4 - 13.2) compared with the risk for women without prior preeclampsia. When there were signs that the preeclampsia in a previous pregnancy had been serious either because the baby was delivered preterm or had died in the perinatal period, the recurrence risk of preeclampsia was even higher. Women who had preeclampsia had increased risk of a series of adverse pregnancy outcomes in future pregnancies. These include perinatal death (RR= 4.3), a baby with low birth weight (RR= 3.5), or a preterm birth (RR= 2.5). These risks were only partly explained by recurrence of preeclampsia.ConclusionsPreeclampsia in one pregnancy is a strong predictor for preeclampsia and other adverse pregnancy outcomes in subsequent pregnancies in Tanzania. Women with previous preeclampsia may benefit from close follow-up during their pregnancies.

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Section: Discussionsupporting

confidence: 63%

“…Some studies in Africa have reported recurrence risks of hypertension [12,13]. However, these studies were based on cross-sectional data and had limited sample size.…”

Section: Introductionmentioning

confidence: 99%

Recurrence of Preeclampsia in Northern Tanzania: A Registry-Based Cohort Study

et al. 2013

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“…It has been recommended for pregnant women to visit antenatal care providers at least one time during the first trimester, twice during the second trimester, and five times during the third trimester [24]. While reasons for the overall overutilization of antenatal care have not been explored in the study, such behavior could be a result of pregnancy complications or anxiety in women classified as at high risk of such complications [25]. The concerning lack of the perceived value of antenatal care and its association with women's education, previously identified by [26] in a local study, remains to be an important and long-manifested barrier to the utilization of maternal health services in many low-income settings [27,28].…”

Section: Discussionmentioning

confidence: 99%

Understanding Barriers and Facilitators of Maternal Health Care Utilization in Central Myanmar

Milkowska-Shibata¹,

Aye

et al. 2020

IJERPH

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The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation (p ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery (p < 0.01). Utilization of postnatal care services was irregular (47.9%–70.9%) and strongly associated with women’s places of delivery (p < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.

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“…En fait, le nombre de visites prénatales des femmes ayant une grossesse à risque dépasse cinq au Zimbabwe [28]. Cependant, dans d'autres études concernant le pronostic de la grossesse et de l'accouchement chez les femmes ayant comme facteur de risque l'âge avancé, le nombre moyen de visites prénatales chez celles-ci est de 5,1 alors qu'il est de 7,5 chez les femmes jeunes [29].…”

Section: Discussionunclassified

Epidemiology of high risk pregnancy in Sousse, Tunisia

Bouafia¹,

Mahjoub²,

Nouira³

et al. 2013

East Mediterr Health J

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RÉSUMÉ la présente étude descriptive a évalué la fréquence de certains facteurs de risque pour la grossesse à haut risque chez les femmes de la région de Sousse. Elle a été menée du 15 février au 15 août 2005 auprès de l'ensemble des femmes ayant accouché au-delà de 28 semaines d'aménorrhée dans quatre maternités publiques et présentant au moins un facteur de risque. La collecte des données a été effectuée dans les 24 heures qui ont suivi l'accouchement à partir des dossiers obstétricaux et fiches de consultation prénatale et par entretien. Sur 4660 femmes, 1194 (25,6 %) avaient au moins un facteur de risque et étaient considérées comme des grossesses à risque. Les femmes à risque avaient un âge moyen de 31,3 ans (ET 5,4) ; 73 % étaient d'origine urbaine, 38 % avaient un niveau d'étude secondaire ou supérieure et 75 % étaient des femmes au foyer. La moyenne des facteurs de risque est de 1,5 par femme. La majorité des femmes (59,3 %) avaient un facteur de risque et 30,4 % en avaient deux. La moyenne des visites prénatales était de 4 ; 68,6 % ont été assurées par un obstétricien et 43 % des femmes ont recouru au secteur privé. Certains facteurs ont été insuffisamment dépistés : âge > 35 ans, parité > 4, antécédent de faible poids de naissance et de décès néonatal, hauteur utérine excessive et anémie. This descriptive study assessed the frequency of selected risk factors for high risk pregnancy (HRP) among women in Sousse region. All pregnant women (beyond 28 weeks gestation) giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factor were enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 (25.6%) had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 (SD 5.4) years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women (59.3%) had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age > 35 years, parity > 4, previous low birth weight and neonatal death, excessive fundal height and anaemia.

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Does maternity care improve pregnancy outcomes in women with previous complications? A study from Zimbabwe

Cited by 4 publications

References 18 publications

Recurrence of Preeclampsia in Northern Tanzania: A Registry-Based Cohort Study

Recurrence of Preeclampsia in Northern Tanzania: A Registry-Based Cohort Study

Understanding Barriers and Facilitators of Maternal Health Care Utilization in Central Myanmar

Epidemiology of high risk pregnancy in Sousse, Tunisia

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