Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Byamukama, Onesmus; Migisha, Richard; Kalyebara, Paul Kato; Tibaijuka, Leevan; Lugobe, Henry Mark; Ngonzi, Joseph; Ahabwe, Onesmus Magezi; Garcia, Kenia Raquel Martinez; Mugyenyi, Godfrey R; Boatin, Adeline A.; Muhumuza, Joy; Ssalongo, Wasswa; Kayondo, Musa; Kanyesigye, Hamson

doi:10.1186/s12884-022-04611-4

Cited by 11 publications

(7 citation statements)

References 29 publications

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“…Furthermore, oligohydramnios may be contributing to the high rates of cesarean section deliveries; fetal distress caused by oligohydramnios has been identified as one of the leading indications for cesarean section deliveries in Uganda [ 11 ]. MRRH, in particular, has been found to have high cesarean section delivery rates of more than 25% [ 12 , 13 ]. This study aimed to determine the prevalence and associated factors of oligohydramnios among women attending antenatal care at > 36 weeks of gestation at MRRH in Southwestern Uganda.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of oligohydramnios in pregnancies beyond 36 weeks of gestation at a tertiary hospital in southwestern Uganda

Twesigomwe

Migisha²,

Agaba³

et al. 2022

BMC Pregnancy Childbirth

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Background Oligohydramnios is associated with poor maternal and perinatal outcomes. In low-resource countries, including Uganda, oligohydramnios is under-detected due to the scarcity of ultrasonographic services. We determined the prevalence and associated factors of oligohydramnios among women with pregnancies beyond 36 weeks of gestation at Mbarara Regional Referral Hospital (MRRH) in Southwestern Uganda. Methods We conducted a hospital-based cross-sectional study from November 2019 to March 2020. Included were women at gestational age > 36 weeks. Excluded were women with ruptured membranes, those in active labour, and those with multiple pregnancies. An interviewer-administered structured questionnaire was used to capture demographic, obstetric, and clinical characteristics of the study participants. We determined oligohydramnios using an amniotic fluid index (AFI) obtained using an ultrasound scan. Oligohydramnios was diagnosed in participants with AFI ≤ 5 cm. We performed multivariable logistic regression to determine factors associated with oligohydramnios. Results We enrolled 426 women with a mean age of 27 (SD ± 5.3) years. Of the 426 participants, 40 had oligohydramnios, for a prevalence of 9.4% (95%CI: 6.8–12.6%). Factors found to be significantly associated with oligohydramnios were history of malaria in pregnancy (aOR = 4.6; 95%CI: 1.5–14, P = 0.008), primegravidity (aOR = 3.7; 95%CI: 1.6–6.7, P = 0.002) and increasing gestational age; compared to women at 37–39 weeks, those at 40–41 weeks (aOR = 2.5; 95%CI: 1.1–5.6, P = 0.022), and those at > 41 weeks (aOR = 6.0; 95%CI: 2.3–16, P = 0.001) were more likely to have oligohydramnios. Conclusion Oligohydramnios was detected in approximately one out of every ten women seeking care at MRRH, and it was more common among primigravidae, those with a history of malaria in pregnancy, and those with post-term pregnancies. We recommend increased surveillance for oligohydramnios in the third trimester, especially among prime gravidas, those with history of malaria in pregnancy, and those with post-term pregnancies, in order to enable prompt detection of this complication and plan timely interventions. Future longitudinal studies are needed to assess clinical outcomes in women with oligohydramnios in our setting.

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Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of oligohydramnios in pregnancies beyond 36 weeks of gestation at a tertiary hospital in southwestern Uganda

Twesigomwe

Migisha²,

Agaba³

et al. 2022

BMC Pregnancy Childbirth

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“…A recent meta-analysis research revealed that women with SBPI had nearly 1.5 times the odds of developing either a preterm or low-birthweight infant (David et al, 2017). A United States study (Byamukama et al, 2022) showed that SBPI was associated with premature rupture of membranes. Another systematic review study in China (Xu et al, 2022) found that short birth spacing was associated with an increased risk of uterine rupture, placenta previa, and placental abruption.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Agulu,

Dzotsi,

Issah

et al. 2024

ESJ

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Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33-month interval between two successive births, to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI) and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana. Materials and Methods: We employed a cross-sectional design conducted among 904 women aged 15-49 attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. A multistage cluster sampling technique was employed to recruit respondents for this study. This was conducted in four steps. Out of the 46 health facilities, we randomly selected 25 respondents using the systematic random selection method. Data was collected using a structured questionnaire, incorporated into the electronic data collection tool (Kobo collect), and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification: <24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI), and >59 months as Long Birth to Pregnancy Interval (LBPI). Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of woman’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02–10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09–3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), low birth weight (19%), and preterm birth (14.3%). Conclusion: A significant proportion of the participants in this study reported having a short duration between the birth of one child and the conception of the next. This was associated with various adverse maternal and perinatal outcomes, such as birth complications and mortalities. The study emphasizes the need for health professionals to address challenges in contraceptive uptake, especially among multiparous women, and promote optimal birth spacing to improve maternal and perinatal outcomes.

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“…The Postnatal Ward is managed by a team of 2 obstetricians, 18 midwives, and 12 residents skilled in deliveries, including cesarean sections. The hospital handles approximately 12,000 deliveries annually, with 40 to 45% delivered through cesarean section [16,17]. Mothers and their newborns receive care at the Postnatal Ward.…”

Section: Study Settingmentioning

confidence: 99%

“…These ndings underscored EONS as the predominant cause of morbidity and mortality among newborns admitted at MRRH, a majority of whom were delivered by cesarean section. The high prevalence of group B streptococci at 28.8% among pregnant women attending antenatal care (ANC) at MRRH [15], combined with a high caesarean section rate ranging from 40-45% at MRRH [16,17], poses a risk for EONS. Despite these facts, maternal factors associated with EONS among term babies delivered by caesarean section at MRRH have not been documented.…”

Section: Introductionmentioning

confidence: 99%

Maternal factors associated with early-onset neonatal sepsis among term babies delivered by caesarean section: a case-control study at Mbarara Regional Referral Hospital, Uganda

Maisaba,

Migisha,

Owaraganise

et al. 2024

Preprint

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Background: Babies born by caesarean section in low-income settings are at increased risk for early-onset neonatal sepsis (EONS), which has higher mortality than late-onset sepsis. However, maternal factors contributing to EONS among cesarean-delivered babies in these settings, including Uganda, are not well documented. We determined maternal factors associated with EONS among term babies delivered by caesarian section at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Methods: We conducted an unmatched case-control study at MRRH from December 2019 to March 2020. Cases were term newborns delivered by caesarean section with EONS (within 72 hours). Controls were term newborns delivered by cesarean section at MRRH without EONS. We enrolled mother-baby pairs for both groups, obtaining maternal data via structured questionnaires The diagnosis of EONS was made using the WHO Young Infant Integrated Management of Childhood Illnesses algorithm. Cases were consecutively recruited while controls were recruited by simple random sampling in a ratio of 1:2. We used multivariable logistic regression analysis to identify maternal factors associated with EONS. Results: We enrolled 52 cases and 104 controls. The mean age for the mothers was 27 (±5.5) years. Neonates born to referred mothers had higher odds of EONS than those born to non-referred mothers (AOR=6.21, 95% CI: 1.81–21.31). Additionally, decision-to-delivery time >1 hour for emergency caesarean section (AOR=16.44, 95% CI: 4.17–64.8), antepartum hemorrhage (AOR=7.97, 95% CI: 1.59–39.95, p=0.012), primiparity (AOR=4.81, 95% CI: 1.11–20.78), and >3 vaginal examinations after membrane rupture (AOR=4.25, 95% CI: 1.54 - 11.72) were associated with EONS. Conclusions: Prime gravidity, antepartum hemorrhage, multiple vaginal examinations after membrane rupture, long decision-to-delivery time, and referral status were associated with EONS among term babies delivered by caesarean section at MRRH. To reduce EONS risk, clinicians should limit post-membrane rupture vaginal exams or consider prophylactic antibiotics if multiple exams are needed. Screening babies born to primiparous women, those referred, those with antepartum hemorrhage, multiple vaginal exams after membranes rupture, and long decision-to-delivery times, could aid prompt recognition of EONS and timely interventions. Implementing standard procedures to reduce caesarean decision-to-delivery time could reduce risk for EONS in this setting.

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Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Cited by 11 publications

References 29 publications

Prevalence and associated factors of oligohydramnios in pregnancies beyond 36 weeks of gestation at a tertiary hospital in southwestern Uganda

Prevalence and associated factors of oligohydramnios in pregnancies beyond 36 weeks of gestation at a tertiary hospital in southwestern Uganda

Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Maternal factors associated with early-onset neonatal sepsis among term babies delivered by caesarean section: a case-control study at Mbarara Regional Referral Hospital, Uganda

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