Prevalence, risk factors and short-term consequences of adverse birth outcomes in Zimbabwean pregnant women: a secondary analysis of a cluster-randomized trial.

Autor:	Chasekwa B; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Ntozini R; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Church JA; Blizard Institute, Queen Mary University of London, London, UK., Majo FD; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Tavengwa N; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Mutasa B; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Noble C; Blizard Institute, Queen Mary University of London, London, UK., Koyratty N; Department of Population Medicine and Diagnostics, Cornell University, Ithaca, NY, USA., Maluccio JA; Department of Economics, Middlebury College, Middlebury, VT, USA., Prendergast AJ; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.; Blizard Institute, Queen Mary University of London, London, UK.; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Humphrey JH; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Smith LE; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.; Department of Population Medicine and Diagnostics, Cornell University, Ithaca, NY, USA.
Jazyk:	angličtina
Zdroj:	International journal of epidemiology [Int J Epidemiol] 2022 Dec 13; Vol. 51 (6), pp. 1785-1799.
DOI:	10.1093/ije/dyab248
Abstrakt:	Background: Globally, 15 million children are born preterm each year and 10.7 million are born at term but with low birthweight (<2500 g). Methods: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) cluster-randomized trial enrolled 5280 pregnant women between 22 November 2012 and 27 March 2015 to test the impact of improved water supply, sanitation and hygiene, and improved infant feeding, on child growth and anaemia. We conducted a secondary analysis to estimate the prevalence and risk factors of miscarriage, stillbirth, preterm birth, size small for gestational age (SGA), low birthweight (LBW), perinatal mortality, and neonatal mortality, and to estimate the effects of adverse birth outcomes on infant survival and growth. Results: The prevalence of adverse birth outcomes was: miscarriage: 5.0% [95% confidence interval (CI), 4.4, 5.7]; stillbirth: 2.3% (95% CI 1.9, 2.7); preterm birth: 18.2% (95% CI 16.9, 19.5); SGA: 16.1% (95% CI 15.0, 17.3); LBW: 9.8% (95% CI 9.0, 10.7); and neonatal mortality: 31.4/1000 live births (95% CI 26.7, 36.5). Modifiable risk factors included maternal HIV infection, anaemia, lack of antenatal care and non-institutional delivery. Preterm infants had higher neonatal mortality [risk ratio (RR): 6.1 (95% CI 4.0, 9.2)], post-neonatal infant mortality [hazard ratio (HR): 2.1 (95% CI 1.1, 4.1)] and stunting at 18 months of age [RR: 1.5 (95% CI 1.4, 1.7)] than term infants; 56% of stillbirths and 57% of neonatal deaths were among preterm births. Conclusions: Neonatal mortality and stillbirth are high in Zimbabwe and appear to be driven by high preterm birth. Interventions for primary prevention of preterm birth and strengthened management of preterm labour and ill and small neonates are required to reduce neonatal mortality in Zimbabwe and other African countries with similar profiles. (© The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association.)
Databáze:	MEDLINE
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