Prevalence and perinatal outcomes of non-communicable diseases in pregnancy in a regional hospital in Haiti: A prospective cohort study.
| Autor: | Malhamé I; Department of Medicine, McGill University Health Centre, Montreal, Canada., Destiné R; Department of Medicine, Saint-Nicolas Hospital, Saint-Marc, Haiti., Jacquecilien W; Department of Medicine, Saint-Nicolas Hospital, Saint-Marc, Haiti., Coriolan BH; Department of Medicine, McGill University Health Centre, Montreal, Canada., St-Loth W; Department of Obstetrics and Gynecology, Saint-Nicolas Hospital, Saint-Marc, Haiti., Excellent MC; Department of Paediatrics, Saint-Nicolas Hospital, Saint-Marc, Haiti., Scaide B; Department of Medicine, Saint-Nicolas Hospital, Saint-Marc, Haiti., Wong R; Department of Medicine, McGill University Health Centre, Montreal, Canada., Meltzer S; Department of Medicine, McGill University Health Centre, Montreal, Canada., Jean-Baptiste E; Fondation Haïtienne de Diabète et de Maladies Cardiovasculaires, Port-au-Prince, Haiti., Pilote L; Department of Medicine, McGill University Health Centre, Montreal, Canada., von Oettingen JE; Department of Paediatrics, McGill University Health Centre, Montreal, Canada., Israel K; Department of Medicine, Saint-Nicolas Hospital, Saint-Marc, Haiti. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of global health [J Glob Health] 2021 Apr 17; Vol. 11, pp. 04020. Date of Electronic Publication: 2021 Apr 17. |
| DOI: | 10.7189/jogh.11.04020 |
| Abstrakt: | Background: The prevalence of non-communicable diseases (NCDs) is rising in low and middle-income countries (LMIC). We aimed to report on the prevalence of NCDs in pregnancy and their associated perinatal outcomes in a regional hospital in Haiti. Methods: We conducted the "Diabète et hYpertension Artéerielle et leurs issues MAternelles et Néonatales" (DYAMAN) prospective cohort study in a regional hospital in Haiti. Pregnant women presenting to care at 24-28 weeks were screened and treated for diabetes (DM) and hypertensive disorders of pregnancy (HDP) using setting-adapted protocols. Prevalence of NCDs and associated maternal-neonatal outcomes were described. Results: 715 women were included, of which 51 (7.1%) had DM, 90 (12.6%) had HDP, and 30 (4.2%) had both DM and HDP (DM/HDP). Of 422 (59%) women delivered in hospital, 58 (13.7%) had preeclampsia, including 5 (8.6%) with eclampsia. Preterm birth <32 weeks was more common in the HDP than the control, DM, and DM/HDP groups. More low birth weight babies (n = 20, 25.6%) were born to the HDP group than to the control (n = 20, 7.1%), DM (n = 1, 2.7%), and DM/HDP (n = 3, 12%) groups ( P < 0.001). Macrosomia and hypoglycemia affected 5 (8%) neonates of women with DM. Perinatal mortality, affecting 36/1000 births, was mainly driven by maternal NCDs. Conclusions: NCDs in pregnancy led to adverse maternal and perinatal outcomes. This study will help to prepare future refinements aimed at optimizing the management of NCDs in pregnancy in LMIC. Research is required to understand barriers to patient attendance at antenatal follow-up, treatment escalation for hyperglycemia, and in-hospital delivery. Competing Interests: Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest. (Copyright © 2021 by the Journal of Global Health. All rights reserved.) |
| Databáze: | MEDLINE |
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