scholarly journals Determinants of adverse birth outcomes among women delivered in public hospitals of Ethiopia, 2020

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Reta Tsegaye ◽  
Adugna Oluma ◽  
Eba Abdisa ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Birth Outcome ◽  
Dietary Supplementation ◽  
Public Hospitals ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Premature Rupture ◽  
Induced Hypertension ◽  
Western Ethiopia

Abstract Background Adverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia. Methods An institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies’ medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05. Results A total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome. Conclusion Low antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

scholarly journals Determinants of adverse birth outcome in Tigrai region, North Ethiopia: Hospital-based case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Helen Tsehaye Hailemichael ◽  
Gurmesa Tura Debelew ◽  
Haileselasie Berhane Alema ◽  
Meresa Gebremedhin Weldu ◽  
Kebede Haile Misgina
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Public Hospitals ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Dietary Counseling ◽  
Planning Methods

Abstract Background Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia. Methods Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05. Result The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15–13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92–36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35–17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89–13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83–14.01] were significantly associated with adverse birth outcomes. Conclusion and recommendation The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.

scholarly journals Adverse birth outcomes among women who gave births at Eastern Ethiopian Hospitals: a cross sectional study

2020 ◽  
Author(s):  
Teshale Mulatu Dibisa ◽  
Adera Debela Kebede ◽  
Tilaye Feto Gelano ◽  
Yadeta Dessie Bacha ◽  
Kemal Jemal
Keyword(s):  
Birth Outcomes ◽  
Birth Outcome ◽  
Multiple Pregnancy ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
History Of

Abstract Background Adverse births outcomes (ABO) such as preterm birth, low birth weight (LBW) and stillbirth are important determining of neonatal morbidity and mortality. It is the major public health problem in low resourced countries. Despite many efforts to reduce neonatal morbidity and mortality, adverse birth outcomes in hospitals has remained high. Therefore, this study aimed to assess the prevalence and factors associated with adverse birth outcomes among women who gave birth at selected public hospitals in Eastern Ethiopia. Methods Facility based cross-sectional study design was conducted in February 2017. Data were collected using a pretested and structured face to face interviewer-administered questionnaire. Binary logistic regression was used to analyze the association between the dependent and independent variables. Results A total of 555 women who give births were involved from four hospitals in Eastern Ethiopia. The prevalence of low birth weight, stillbirth and preterm births were 40(7.2%), 37(6.7%) and 28(5%) respectively. The overall prevalence of adverse birth outcomes was 76(13.7%). Four-ninth 247(44.5%) of mothers had high-risk pregnancies. Hypertension [AOR = 7.25; 95%, CI= (1.71, 30.64)], history of adverse birth outcome [AOR = 12.12; 95%, CI= (6.5, 22.6)], multiple pregnancy [AOR = 6.94; 95%, CI= (2.74, 17.53)] and spontaneous vaginal delivery [AOR = 0.11; 95%, CI= (0.44, 0.16)] were associated with adverse birth outcome. Conclusion In this study adverse birth outcomes were still found as public health problems. Hypertension, history of adverse birth outcome, multiple pregnancy and spontaneous vaginal delivery were significantly associated with ABO. Thus, developing strategies to prevent and treat complications during pregnancy and increasing maternal health utilization at ANC clinics are warranted.

scholarly journals Adverse Birth Out Comes and Associated Factors among Delivered Mothers in Dessie Referral Hospital, North East Ethiopia

2017 ◽  
pp. 1-6 ◽  
Author(s):  
Niguss Cherie ◽  
Amare Mebratu
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Hemoglobin Level ◽  
Referral Hospital ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Significance Level ◽  
Dessie Referral Hospital

Introduction: Though there are studies on the various forms of adverse birth outcomes particularly in developing countries, there is limited information on determinant maternal and fetal factors of adverse birth outcomes at Dessie referral hospital including north east Ethiopia. Objective: To assess adverse birth outcomes and associated factors among delivered mothers in Dessie referral hospital, Dessie, Ethiopia. Methods: Institutional based cross sectional study design was conducted in Dessie referral hospital from February 30-March 30, 2017. Random sampling technique was used and 462 sample size was deployed. The collected data was checked; coded and entered to Epi info 7.3 and exported to SPSS version 20 for further analysis. Bivariate logistic regression model used to determine the independent association of dependent and independent variables on the bases of COR; 95 percent of confidence level and significance level of 0.25 Those variables which had significance level of less than 0.25 transferred to multivariable logistic regression. Multivariable logistic regression also used to control the possible effects of confounder variables on the basis of AOR; 95 percent of confidence level and significance level of 0.05. Result: A total of 462 delivered mothers participated in this study which yields 100% response rate. The study finding showed that the proportion of adverse birth outcome among the study participants was 32.5%. Out of 462 births 8.2% were still birth, 16.7% were low birth weight, 15.2% preterm and 8.4% were with visible birth defects. Mothers who didn’t attend antenatal care were 4 times more likely to have adverse birth outcome when compared to those who attended antenatal care follow up, [AOR=4.01, 95% CI(2.8,8.3 )]. Similarly, mothers with hemoglobin level less than 11 mg/dl were encountered adverse birth outcomes 3 times more when compared to those with hemoglobin level greater or equal to 11 mg/dl [AOR=3.04, 95% CI(1.62, 5.71)]. The presence of any form of pregnancy complication to current pregnancy were 3 times more likely to result in adverse birth outcomes as compared to no complication [AOR=2.9, 95% CI (1.64, 5.15)]. Conclusion and Recommendation: proportion of adverse birth outcome among the study participants was high. Lack of antenatal care, hemoglobin level, and pregnancy complications, middle upper arm circumference, were predictors of adverse birth outcomes. Increasing antenatal care uptake, prevention and treatment of chronic medical illness, and anemia and improvements in quality of maternal health services require strict attention.

scholarly journals Determinants of preterm birth among women delivered in public hospitals of Western Ethiopia, 2020: Unmatched case-control study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245825
Author(s):  
Muktar Abadiga ◽  
Bizuneh Wakuma ◽  
Adugna Oluma ◽  
Ginenus Fekadu ◽  
Nesru Hiko ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Antenatal Care ◽  
Case Control Study ◽  
Care Service ◽  
Case Control ◽  
Pregnancy Induced Hypertension ◽  
Premature Rupture ◽  
Induced Hypertension ◽  
Western Ethiopia ◽  
Control Study

Background Worldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia. Methods An institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05. Results From a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn’t get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth. Conclusion Antenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

scholarly journals Adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia: Systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241811
Author(s):  
Demeke Mesfin Belay ◽  
Wubet Alebachew Bayih ◽  
Abebaw Yeshambel Alemu ◽  
Aklilu Endalamaw Sinshaw ◽  
Demewoz Kefale Mekonen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Outcomes ◽  
Associated Factors ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Pooled Prevalence ◽  
History Of

Background The magnitude of adverse birth outcome among diabetic pregnant women is high in low-and-middle income countries, like Ethiopia. Precise epidemiological evidence is necessary to plan, evaluate and improve effective preventive measures. This systematic review and meta-analysis is the first to estimate the pooled prevalence of adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia. Methods PubMed, Cochrane Library, Google Scholar, SCOPUS, Web of Science and PsycINFO, and article found in University online repository were accessed. Observational studies such as cross-sectional, case-control and prospective cohort reported using English language was involved. I2 statistic was used to check heterogeneity. Egger’s test and funnel plot were used to measure publication bias. Weighted inverse variance random effects model was also performed. Results Seven studies with 1,225 study participants were retrieved to estimate the pooled prevalence of adverse birth outcome and associated factors. The pooled prevalence of adverse birth outcome among diabetic pregnant women was 5.3% [95% CI; 1.61, 17.41]. Fasting blood glucose level above 100 mg/dl [Adjusted Odds ratio (AOR) = 10.51; 95% Confidence Interval (CI) = 5.90, 15.12], two hour post prandial glucose level above 120 mg/dl [AOR = 8.77; 95% CI = 4.51, 13.03], gestational age <37 completed week [AOR = 9.76; 95% CI = 5.29, 14.23], no ANC follow-up [AOR = 10.78; 95% CI = 6.12, 15.44], history of previous adverse outcomes [AOR = 3.47; 95% CI = 1.04, 5.90], maternal age < 30 years [AOR = 3.47; 95% CI = 1.04, 5.90], and illiteracy [AOR = 2.89; 95% CI = 0.81,4.97)] were associated factors of adverse birth outcome. Conclusions The pooled prevalence of adverse birth outcomes among diabetic pregnant women in Ethiopia was high. Child born from mothers who were illiterate, maternal age < 30 years, gestational age < 37 completed weeks, history of previous adverse birth outcomes and no ANC follow-up increased the risk of adverse birth outcome. Trial registration It is registered in PROSPERO data base: (PROSPERO 2020: CRD42020167734).

scholarly journals Birth Outcomes among Diabetic Mothers Who Delivered in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bajrond Eshetu ◽  
Yitagesu Sintayehu ◽  
Bazie Mekonnen ◽  
Woreknesh Daba
Keyword(s):  
Diabetes Mellitus ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Fetal Outcome ◽  
Maternal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Class I Obesity ◽  
Induced Hypertension ◽  
History Of ◽  
Diabetic Mothers

Introduction. Diabetes develops in 4% of all the pregnancies worldwide, and its prevalence ranges from 1 to 14%, and 7% are complicated and results in prenatal morbidity and mortality. The disease affects women and their babies during pregnancy, labor, and delivery. However, little is known about its prevalence, birth outcomes, and associated factors in the study setting. Method. A facility-based retrospective cross-sectional study was done on all deliveries attended from January 1, 2015, to December 31, 2017, to determine the prevalence of diabetes and birth outcome. The mothers who had complete data record were identified and consecutively reviewed. The data were entered in EpiData Version 4.2 and exported to SPSS Version 23.0 for analysis. Results. Of the 14039 women who gave birth during the study period, 2.6% of them had diabetes mellitus, and from reviewed data, 54.6% had gestational diabetes and 45.4% had pregestational diabetes. Out of the diabetic mothers, 57.8% delivered by cesarean section, 39.9% by spontaneous vaginal delivery, and 26% of the pregnancies ended up with pregnancy-induced hypertension. Regarding the fetal outcome, 17.9% were preterm delivery, 17.6% macrocosmic, 9.2% respiratory distress, 10.1% low birth weight, and 65% admitted to neonatal intensive care unit. Class I obesity and history of PIH were associated with adverse maternal outcomes at aOR = 95%CI 3.8 (1.29, 8.319) and aOR = 95%CI 2.1 (1.03, 4.399), respectively. Being a house wife and preterm deliveries were associated with adverse fetal outcomes at aOR = 95%CI 2.117 (1.315, 3.405) and aOR = 95%CI 9.763 (4.560, 20.902), respectively. Conclusion. The prevalence of diabetes mellitus delivered in the hospital was 2.6%. Class I obesity and previous history of pregnancy-induced hypertension were significantly associated with adverse maternal outcomes, whereas preterm delivery and being housewife were associated with adverse fetal outcome.

scholarly journals Determinants of preterm birth in public hospitals in central Ethiopia: an unmatched case-control study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 773
Author(s):  
Berhanu Senbeta Deriba ◽  
Agumas Fentahun Ayalew ◽  
Addis Adera Gebru
Keyword(s):  
Preterm Birth ◽  
Cigarette Smoking ◽  
Birth Outcomes ◽  
Case Control Study ◽  
Case Control ◽  
Public Hospitals ◽  
Medical Illness ◽  
Adverse Birth Outcomes ◽  
Central Ethiopia ◽  
Control Study

Background: Around 15 million babies are born prematurely in the world every year. The most common cause of neonatal death in Ethiopia is premature birth. To reduce the rate of preterm delivery by correcting modifiable or preventable causes, the availability of local data is important. Hence, this study aimed to identify the determinants of preterm birth among women who gave birth in public hospitals in central Ethiopia. Methods: An Institutional-based unmatched case-control study was conducted at public hospitals in central Ethiopia to select 170 cases and 340 controls. The collected data were entered into EPI INFO and transferred to SPSS for analysis. Tables, graphs, and proportions were used to present the results. Binary and multiple logistic regressions analysis were computed to identify determinants of preterm birth. Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI), and a p-value < 0.05 were computed to determine the presence of an association between preterm birth and independent variables. Results: A total of 166 cases and 332 controls participated in the study, giving a response rate of 97.6%. Cigarette smoking (AOR=3.77, 95% CI=1.35,10.56), alcohol consumption (AOR=1.85, 95% CI=1.11,3.10), wanted but unplanned pregnancy (AOR=3,95% CI=1.68,5.34), neither wanted nor planned pregnancy(AOR=3.61% CI=1.62,8.06), lack of antenatal care (ANC) visits (AOR=4.13, 95% CI=1.95, 8.74), adverse birth outcomes (AOR=5.66, 95% CI=2.88,11.12), presence of a diagnosed illness (AOR=2.81, 95% CI=1.37, 5.76), presence of one or more of obstetrics complications(AOR=6.44, 95% CI=5.49, 3.35, 9), and hemoglobin level < 11g/dl  (AOR=2.78, 95% CI=1.48, 5.22) were determinants of preterm birth. Conclusion:-In this study, cigarette smoking status, alcohol drinking status, pregnancy status, adverse birth outcomes, ANC visits, obstetric complications,  presence of medical illness, and anemia were identified as determinants of preterm birth. It is important to encourage such women to attend ANC visits, stop smoking, and abstain from alcohol.

scholarly journals Prenatal maternal stress and birth outcomes in rural Ghana: sex-specific associations

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenneth Ayuurebobi Ae-Ngibise ◽  
Blair J. Wylie ◽  
Ellen Boamah-Kaali ◽  
Darby W. Jack ◽  
Felix Boakye Oppong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Birth Outcomes ◽  
Fetal Growth ◽  
Head Circumference ◽  
Maternal Stress ◽  
Birth Outcome ◽  
Sub Saharan Africa ◽  
Adverse Birth Outcome ◽  
Prenatal Maternal Stress ◽  
Rural Ghana

Abstract Background In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana. Methods Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined. Results In all children, high prenatal maternal stress was associated with reduced birth length (β = − 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = − 0.16, p = 0.02; β = − 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = − 0.66, p = 0.05; β = − 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys. Conclusions All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies. Trial registration NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.

scholarly journals Adverse Birth Outcomes in Botswana Among Women With Vertically or Horizontally Acquired Human Immunodeficiency Virus

2020 ◽  
Author(s):  
Christina Fennell ◽  
George R Seage ◽  
Rebecca Zash ◽  
Kelesitse Phiri ◽  
Modiegi Diseko ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Neonatal Death ◽  
Regression Models ◽  
Antiretroviral Treatment ◽  
Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Binomial Regression ◽  
Immunodeficiency Virus ◽  
Risk Ratios ◽  
In Pregnancy

Abstract Background Women with vertically acquired HIV (VHIV) may have a greater risk of adverse birth outcomes than women with horizontally acquired HIV (HHIV). Methods The Tsepamo study performed birth outcomes surveillance at 8 government delivery sites in Botswana from July 2014 through March 2019. Pregnant women diagnosed with HIV before their 11th birthday received VHIV status, and other women had HHIV. Small for gestational age (SGA), preterm delivery (PTD), stillbirth, and neonatal death were compared using χ2 and Fisher’s exact tests. Log-binomial regression models determined risk ratios (RRs). Results VHIV women (n = 402) aged 15–27 years were identified over 4 years of surveillance and compared with HHIV women (n = 8465) of the same age. VHIV women were more likely to use nevirapine (NVP)-based antiretroviral treatment (ART) in pregnancy and to have SGA and very SGA infants, but less likely to have very PTD infants. In unadjusted analyses, VHIV women had a higher risk of any adverse birth outcome combined (RR = 1.21, 95% confidence interval [CI], 1.08–1.36). After adjusting for potential confounders, particularly use of NVP-based regimens, the risk of adverse birth outcomes among VHIV and HHIV women was similar. Conclusions NVP-based ART is a primary and modifiable risk factor for adverse birth outcomes. Updating ART regimens could improve birth outcomes for women with HIV.

Meta-Analysis Finds Use of Inhaled Corticosteroids During Pregnancy Safe: A Systematic Meta-Analysis Review

2006 ◽  
Vol 25 (8) ◽  
pp. 447-452 ◽  
Author(s):  
R Rahimi ◽  
S Nikfar ◽  
M Abdollahi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Inhaled Corticosteroids ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Drug Of Choice ◽  
Term Delivery ◽  
Induced Hypertension

Inhaled corticosteroids (ICs) are the drug of choice for asthmatic women during pregnancy, but the results on the effects of these medications on obstetrical and perinatal outcomes are not conclusive. Meta-analysis is the statistical analysis of a collection of analysis results from individual studies for the purpose of integrating the findings. Meta-analysis techniques are necessary because only summary statistics are available in the literature. In order to determine the risk of exposure to ICs, we pooled data from all clinical studies that evaluated the pregnancy and perinatal outcomes in women exposed to this group of drugs during pregnancy by the meta-analytic technique. PUBMED, OVID, EMBASE and SCOPUS databases were searched for studies that investigated birth outcome following exposure to ICs during pregnancy. Data were collected from 1997 to 2005 (up to 31 December). Types of outcome investigated were major malformations, pre-term delivery, low birth weight and pregnancy-induced hypertension. The criteria for inclusion of studies in this meta-analysis were exposure of women to any therapeutic dosage of any ICs (fluticasone, beclomethasone, budesonide, triamcinolone and flunisolide) during pregnancy. The results showed that ICs do not increase the risk of major malformations, preterm delivery, low birth weight and pregnancy-induced hypertension. In conclusion, ICs do not increase the rates of any obstetrical outcomes investigated in the present study and interestingly improve the symptoms and are helpful in the management of asthma and thus can be used comfortably during pregnancy.

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