scholarly journals Risk factors of pregnancy morbidity in migrant women from Subsaharan Africa

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Bezanahary ◽  
B Gutierrez ◽  
S Dumonteil ◽  
P Coste Mazeau ◽  
J L Eyraud ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Maternal Morbidity ◽  
Individual Risk ◽  
Chronic Hypertension ◽  
Migrant Women ◽  
Risk Of Death ◽  
Subsaharan Africa

Abstract Reduction of maternal mortality remains a major public health issue worldwide. In France, the latest national confidential enquiry regarding maternal mortality (2010-2012) stated a ratio of 10 /100 000 livebirths whereas the goal was 5/100 000. The risk of death among pregnant women from Subsaharan Africa (SSA) was 3 times higher. We performed a monocentric observational retrospective study from 01/01/2009 to 01/09/2016 in order to better understand the factors of maternal morbidity among SSA pregnant women. Demographic characteristics as well as pregnancy outcomes were collected. Antenatal clinics attendance was scored (+1 if positive, +1 if done following the recommended schedule). A total 1 489 (7%) out of 20 755 pregnancies were registred among SSA women. Mean age was 29 years (14-48), mean gestity/parity were respectively 3.5 and 1.8. About 38% of pregnancies occured in overweight or obese women. Obstetrical complications were seen in 542 (36%) pregnancies: gestational diabetes (n = 206, 36,4%), hypertensive disorders (n = 122, 8,2%), 19 had both. Pre-eclampsia represented 4%, sepsis 5%, premature rupture of membrane 5% and post partum haemorrhage 3%. Livebirths was high (97%) with a mean gestational age of 37(22-41), a mean birth weight of 3150g (500-5000). The unique maternal death in this cohort was due to amniotic fluid embolism. Complication risk factors were age (30 versus 28 years; p < 0.0001), BMI (26 versus 25 kg/m2; p < 0.0001), past history of chronic hypertension and pregestational diabetes (p < 0,001). Furthermore, the score of antenatal care attendance was low in those who presented pregnancy morbidities (p = 0.0006) (adjusted with age, BMI> 25 and chronic hypertension). Higher risk of maternal morbidity among SSA women is not only explained by individual risk factors but also by a lack of compliance to the recommended antenatal care even if they live in France. Further investigations including sociological studies are therefore needed. Key messages Maternal mortality and morbidity are higher among migrant women from Subsaharan Africa. Our study highlights a non compliance to the recommended antenatal care surveillance among risk factors.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Yasir Salih ◽  
Abubakr M. Nasr ◽  
Abdel B. A. Ahmed ◽  
Manal E. Sharif ◽  
Ishag Adam
Keyword(s):  
Risk Factors ◽  
Periodontal Disease ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Care Clinic

HIV, hepatitis B virus, hepatitis C virus, and syphilis among pregnant women attending antenatal care in Luanda, Angola: Seroprevalence and risk factors

2020 ◽  
Vol 92 (12) ◽  
pp. 3265-3270
Author(s):  
Cruz S. Sebastião ◽  
Zoraima Neto ◽  
Domingos Jandondo ◽  
Marinela Mirandela ◽  
Joana Morais ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Virus Hepatitis ◽  
B Virus

The Low-Molecular-Weight-Heparin, Tinzaparin, Is Effective and Safe in the Treatment and Prophylaxis of Venous Thromboembolic Disease during Pregnancy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1774-1774 ◽  
Author(s):  
Maja Jorgensen ◽  
Jorn D. Nielsen
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Pregnant Women ◽  
University Hospital ◽  
Individual Risk ◽  
Low Molecular Weight ◽  
Venous Thromboembolic ◽  
Individual Risk Assessment

Abstract During pregnancy the incidence of venous thromboembolism (VTE) is approximately 6 times higher than in age-matched, non-pregnant women and venous thromboembolism remains the most common cause of maternal morbidity and mortality. Low-molecular-weight-heparins are recommended for treatment of VTE during pregnancy and for prophylaxis of VTE in pregnant women with major thromboembolic risk factors. We used tinzaparin for prophylaxis and treatment of VTE in 305 consecutive pregnant women referred to the Thrombosis Centre, Gentofte University Hospital, from 1997 to 2004. In 268 pregnancies the mothers had thrombophilia, 52 women were admitted with acute VTE and 184 had previous VTE. Other clinical risk factors included previous bad obstetric outcome, recurrent miscarriages, cardiac disorders or previous thromboembolic stroke. An individual risk assessment of each pregnant woman was performed. Very high risk females were treated with tinzaparin 90 – 100 IU/kg bid, high risk females were treated with tinzaparin 100 – 125 IU/kg daily and women with moderate risk were treated with 50 – 75 IU/kg daily. 302 of 305 pregnancies (99 %) in 263 females resulted in 310 healthy babies. 306 of 310 babies had appropriate birth weight for gestational week and all babies had normal Apgar score. Two females had miscarriages (week 10 and 20) and 1 female had an elective abortion. No females had pulmonary embolism. Deep venous thrombosis occurred in 4 of 305 pregnancies = 1,3 % (week 6, 11, 27 and one day postpartum). Wound hematoma was observed after cesarean section in two women and postpartum bleeding episodes (700 – 1500 ml) were observed in 7 women (4 had severe vaginal or cervical tearings, 2 had retained placenta and 1 had placental abruption). We found no incidence of thrombocytopenia or symptomatic osteoporosis. We find that individually dosed tinzaparin is safe and seems effective in the prevention of thromboembolic complications during pregnancy. Individual risk stratification is recommended.

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