Risk factors for stillbirths in Tete, Mozambique
Autor: | Diederike Geelhoed, Jocelijn Stokx, Kristien Roelens, Carla das Dores Mosse Lázaro, Xavier Mariano |
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Rok vydání: | 2015 |
Předmět: |
Adult
Pediatrics medicine.medical_specialty Multivariate analysis Adolescent Referral Population HIV Infections Young Adult Pregnancy Risk Factors medicine Humans Childbirth Syphilis education Referral and Consultation Mozambique education.field_of_study business.industry Obstetrics Pregnancy Outcome Case-control study Obstetrics and Gynecology Prenatal Care General Medicine Odds ratio Stillbirth medicine.disease Pregnancy Complications Logistic Models Socioeconomic Factors Case-Control Studies Multivariate Analysis Female business |
Zdroj: | International Journal of Gynecology & Obstetrics. 130:148-152 |
ISSN: | 0020-7292 |
DOI: | 10.1016/j.ijgo.2015.03.027 |
Popis: | Objective To evaluate known risk factors for stillbirth and identify local priorities for stillbirth prevention among institutional deliveries in Tete, Mozambique. Methods A case–control study was conducted among 150 women who experienced stillbirths and 300 women who experienced live deliveries at three health facilities between December 1, 2009, and April 30, 2011. Case and control individuals were matched for health facility, age, and parity. Sociodemographic, pregnancy, and delivery characteristics (including HIV and syphilis serology) were assessed. Bivariate associations and a conditional logistic regression model identified variables contributing to fetal outcome. Results No between-group differences were recorded in the frequency of infection with HIV (25 [16.7%] cases vs 55 [18.3%] controls; P = 0.663) or syphilis (6 [4.0%] vs 16 [5.3%]; P = 0.536) at delivery. Multivariate analysis revealed that stillbirth was associated with direct obstetric complications (mutually adjusted odds ratio [OR] 6.7; 95% confidence interval [CI] 3.6–12.1), low socioeconomic status (mutually adjusted OR 1.8; 95% CI 1.1–3.1), and referral during childbirth (mutually adjusted OR 3.2; 95% CI 1.7–6.1). Conclusion Stillbirths in Tete, Mozambique, were predominantly caused by direct obstetric complications requiring referral among women of low socioeconomic status. Prenatal management of HIV and syphilis limited effects on fetal outcome. Emergency obstetric care and referral systems should be the focus of interventions aimed at stillbirth prevention. |
Databáze: | OpenAIRE |
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