scholarly journals Risk factors for major external structural birth defects among children in Kiambu County, Kenya: a case-control study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 59
Author(s):  
George N. Agot ◽  
Marshal M. Mweu ◽  
Joseph K. Wang'ombe
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Case Control Study ◽  
Case Control ◽  
Categorical Variables ◽  
Surveillance Systems ◽  
Continuous Variables ◽  
Reproductive Health Services ◽  
Multifactorial Inheritance ◽  
Control Study

Background: Although major external structural birth defects continue to occur globally, the greatest burden is shouldered by resource-constrained countries with no surveillance systems. To our knowledge, many studies have been published on risk factors for major external structural birth defects, however, limited studies have been published in developing countries. The objective of this study was to identify risk factors for major external structural birth defects among children in Kiambu County, Kenya. Methods: A hospital-based case-control study was used to identify the risk factors for major external structural birth defects. A structured questionnaire was used to gather information retrospectively on maternal exposure to environmental teratogens, multifactorial inheritance, and sociodemographic-environmental factors during the study participants' last pregnancies.  Descriptive analyses (means, standard deviations, medians, and ranges) were used to summarize continuous variables, whereas categorical variables were summarized as proportions and percentages in frequency tables. Afterward, logistic regression analyses were conducted to estimate the effects of the predictors on the odds of major external structural birth defects in the country. Results: Women who conceived when residing in Ruiru sub-county (adjusted odds ratio [aOR]: 5.28; 95% CI: 1.68-16.58; P<0.01), and Thika sub-county (aOR: 0.27; 95% CI; 0.076-0.95; P =0.04); and preceding siblings with history of birth defects (aOR: 7.65; 95% CI; 1.46-40.01; P =0.02) were identified as the significant predictors of major external structural birth defects in the county. Conclusions: These findings pointed to MESBDs of genetic, multifactorial inheritance, and sociodemographic-environmental etiology. Thus, we recommend regional defect-specific surveillance programs, public health preventive measures, and treatment strategies to understand the epidemiology and economic burden of these defects in Kenya. We specifically recommend the integration of clinical genetic services with routine reproductive health services because of potential maternal genetic predisposition in the region.

scholarly journals Risk factors for major external structural birth defects among children in Kiambu County, Kenya: a case-control study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 59
Author(s):  
George N. Agot ◽  
Marshal M. Mweu ◽  
Joseph K. Wang'ombe
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Maternal Age ◽  
Case Control Study ◽  
Case Control ◽  
Reproductive Age ◽  
Categorical Variables ◽  
Continuous Variables ◽  
History Of ◽  
Control Study

Background: Although major external structural birth defects continue to occur globally, the greatest burden is shouldered by resource-constrained countries largely with no surveillance systems. To the best of our knowledge, few studies have been published on the risk factors for these defects in developing countries. The objective of this study was to identify the risk factors for major external structural birth defects among children in Kiambu County, Kenya. Methods: A hospital-based case-control study was used to identify the risk factors for major external structural birth defects in Kiambu County. A structured questionnaire was used to gather information retrospectively on exposure to environmental teratogens, multifactorial inheritance, and sociodemographic-environmental factors during the study participants' last pregnancies. Descriptive analyses (means, standard deviations, medians, and ranges) were used to summarize continuous variables, whereas, categorical variables were summarized as proportions and percentages in frequency tables. Afterward, logistic regression analyses were conducted to estimate the effects of the predictors on major external structural birth defects in the county. Results: From the multivariable analyses, maternal age ≤34 years old, (aOR: 0.41; 95% CI: 0.18-0.91; P=0.03), and preceding siblings with history of birth defects (aOR: 5.21; 95% CI; 1.35-20.12; P =0.02) were identified as the significant predictors of major external structural birth defects. Conclusions: Maternal age ≥35 years old, and siblings with a history of birth defects were identified as the risk factors for major external structural birth defects in Kiambu County, Kenya. This pointed to a need to create awareness among couples against delaying childbearing beyond 35 years of age and the need for clinical genetic services for women of reproductive age with history of births affected by congenital anomalies.

scholarly journals Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in Addis Ababa, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eskinder Kebede ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Death ◽  
Maternal Education ◽  
Case Control Study ◽  
Addis Ababa ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Death ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, the nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births. Methods This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital and Gandhi Memorial Hospital. All women who had a stillbirth or early neonatal death (i.e. death within 7 days) during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital were approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on risk factors were retrieved from medical records including delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher’s exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal death. Results During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. Records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were 30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal death were low maternal education (aOR 1.747, 95%CI 1.098–2.780), previous stillbirth (aOR 9.447, 95%CI 6.245–14.289), previous preterm birth (aOR 3.620, 95%CI 2.363–5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228–3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523–7.031). Conclusion Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.

Risk Factors for Stillbirth and Early Neonatal Mortality: A Case-Control Study in Tertiary Hospitals in Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Eskinder Kebede Weldetensaye ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
Maternal Education ◽  
Case Control Study ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Mortality ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background: Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, perinatal mortality continues to be a major obstacle. The nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births.Methods: This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital (TAH) and Gandhi Memorial Hospital (GMH). All women who had a stillbirth or early neonatal mortality during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital was approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on potential risk factors were retrieved from medical records including health passports, delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher's exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal mortality.Results: During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. During the study period, records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal mortality were low maternal education (aOR 1.747, 95%CI 1.098-2.780), high parity (aOR 1.114, 95%CI .058- 2.484), previous stillbirth (aOR 9.447, 95%CI 6.245-14.289), previous preterm birth (aOR 3.620, 95%CI 2.363-5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228-3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523-7.031).Conclusion: Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services, particularly for women who have a history of obstetric complications identified as risk factors. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.

scholarly journals Risk Factors of Anaemia among Children under Five Years in the Hohoe Municipality, Ghana: A Case Control Study

Anemia ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Phyllis Atta Parbey ◽  
Elvis Tarkang ◽  
Emmanuel Manu ◽  
Hubert Amu ◽  
Martin Amogre Ayanore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Supplementation ◽  
Case Control Study ◽  
Dietary Diversity ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Categorical Variables ◽  
Children Under Five ◽  
Under Five ◽  
Control Study

Background. Anaemia is one of the major causes of death among children under five years in Ghana. We examined the risk factors of anaemia among children under five years in the Hohoe Municipality, Ghana. Methods. This facility-based matched case control study recruited 210 children (70 cases and 140 controls) aged 6 to 59 months. Stratified and simple random sampling techniques were used to select mothers attending Child Welfare Clinic (CWC) for the screening of their children. Data were collected using a semistructured questionnaire. Finger prick blood was collected to estimate the haemoglobin (Hb) level and thick film was prepared to determine malaria parasitaemia. Axillary temperature was measured using an +electronic thermometer and anthropometric measurements were done using a weighing scale and inelastic tape measure. Continuous variables were presented as means and standard deviations and categorical variables as frequencies and proportions. Conditional logistic regression was used to determine the strength of association between the dependent and the independent variables. Statistical significance was considered at p value of <0.05. Results. The prevalence of anaemia was high (53.8%), while children whose mothers received iron supplementation during pregnancy were 7.64 times more likely to be anaemic compared with those who did not [AOR=7.64 (95% CI:1.41-41.20.93); p=0.018]. Children with poor dietary diversity were 9.15 times more likely to have anaemia [AOR=9.15 (95% CI: 3.13-26.82); p< 0.001]; and children whose mothers were farmers and traders were 83% [AOR = 0.17 (95% CI: 0.05-0.60); p=0.006] and 79% [AOR=0.21 (95% CI: 0.06-0.74); p=0.014], respectively, less likely to have anaemia. Conclusion. The biologic, intermediate, and underlying factors that were significantly associated with anaemia comprised maternal iron supplementation, poor dietary diversity, farmers, and traders. Given that iron supplementation during pregnancy did not protect children against anaemia, we recommend the child’s nutritional dietary diversity is encouraged.

scholarly journals Zika and dengue but not chikungunya are associated with Guillain-Barré syndrome in Mexico: A case-control study

2020 ◽  
Vol 14 (12) ◽  
pp. e0008032
Author(s):  
Israel Grijalva ◽  
Concepción Grajales-Muñiz ◽  
César González-Bonilla ◽  
Victor Hugo Borja-Aburto ◽  
Martín Paredes-Cruz ◽  
...  
Keyword(s):  
Case Control Study ◽  
Acute Infection ◽  
Denv Infection ◽  
Case Control ◽  
Guillain Barre Syndrome ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Control Study

Background Zika, dengue and chikungunya viruses (ZIKV, CHIKV and DENV) are temporally associated with neurological diseases, such as Guillain-Barré syndrome (GBS). Because these three arboviruses coexist in Mexico, the frequency and severity of GBS could theoretically increase. This study aims to determine the association between these arboviruses and GBS in a Mexican population and to establish the clinical characteristics of the patients, including the severity of the infection. A case-control study was conducted (2016/07/01-2018/06/30) in Instituto Mexicano del Seguro Social (Mexican Social Security Institute) hospitals, using serum and urine samples that were collected to determine exposure to ZIKV, DENV, CHIKV by RT-qPCR and serology (IgM). For the categorical variables analysis, Pearson’s χ2 or Fisher exact tests were used, and the Mann-Whitney U test for continuous variables. To determine the association of GBS and viral infection diagnosis through laboratory and symptomatology before admission, we calculated the odds ratio (OR) and 95% confidence intervals (95%CI) using a 2x2 contingency table. A p-value ≤ 0.05 was considered as significant. Ninety-seven GBS cases and 184 controls were included. The association of GBS with ZIKV acute infection (OR, 8.04; 95% CI, 0.89–73.01, p = 0.047), as well as laboratory evidence of ZIKV infection (OR, 16.45; 95% CI, 2.03–133.56; p = 0.001) or Flavivirus (ZIKV and DENV) infection (OR, 6.35; 95% CI, 1.99–20.28; p = 0.001) was observed. Cases of GBS associated with ZIKV demonstrated a greater impairment of functional status and a higher percentage of mechanical ventilation. According to laboratory results, an association between ZIKV or ZIKV and DENV infection in patients with GBS was found. Cases of GBS associated with ZIKV exhibited a more severe clinical picture. Cases with co-infection were not found.

scholarly journals Risk Factors and Complications of Newborns with Birth Defect: A Hospital based Case-Control Study

2019 ◽  
Vol 19 (1) ◽  
pp. 133-140
Author(s):  
Sharmin Afroze ◽  
MA Mannan ◽  
Sanjoy Kumer Dey ◽  
Sadeka Choudhury Moni ◽  
Mohammad Kamrul Hassan Shabuj ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Birth Defect ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Medical Science ◽  
Significant Risk ◽  
Case Control ◽  
Outcome Variable ◽  
Control Study

Background: Birth defect is one of the most important causes of neonatal mortality worldwide. In a developing country like Bangladesh many possible factors for birth defects are present which should be identified. This study was performed to determine those risk factors of birth defect and complications associated with it. Materials and Methods: A hospital based matched case-control study was conducted from August 2015 to July 2016 in department of Neonatology along with Obstetrics and Gynecology at BSMMU. A total of 98 mother-infant pair (49 babies with birth defect as cases and 49 healthy babies without any birth defects as controls) was included in the study. For each case, a gestational age, sex and post-natal age matched control was taken. Data was collected by face to face interview. Univariate and multivariate conditional logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 23.0. Variables with p-value <0.05 were considered statistically significant. Results: The mean (± SD) birth weight for cases and controls were 2718.37 (±756.9) grams, and 2617.14 (±978.8) grams respectively. Cardiovascular system was the predominant system (21%) involved in birth defects. Maternal age between 20-29 years (AOR: 4.69; 95% CI 1.078, 20.448), less than four antenatal care visits (AOR: 10.07; 95% CI 2.816, 36.0), no multivitamin intake (AOR: 7.38; 95% CI 1.791, 30.365) and presence of maternal diabetes (AOR: 0.194; 95% CI 0.047, 0.799) were significantly associated with birth defects among newborns. Sepsis, asphyxia, hypoglycemia and dyselectrolytemia were the most prevalent problems among these babies. The need of intravenous fluid, thermal care, antibiotics and mechanical ventilation was also high among the cases. Conclusion: Birth defect is an upcoming issue in current newborn health situation which need to be prioritized. Significant risk factors should be addressed timely for early diagnosis and proper management of these babies can help in reduction of mortality. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.133-140

scholarly journals Risk factors for stillbirth and early neonatal death: A case-control study in tertiary hospitals in Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Eskinder Kebede Weldetensaye ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Death ◽  
Maternal Education ◽  
Case Control Study ◽  
Addis Ababa ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Death ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background: Globally, Ethiopia is ranked seventh in the absolute number of stillbirths. Attempts to decrease this number have been obstructed by an inadequate understanding of the risk factors leading to stillbirth and early neonatal death in Ethiopia. This study was conducted in two tertiary hospitals in Addis Ababa, Ethiopia, to identify the risk factors for stillbirth and neonatal death in this setting.Methods: This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital (TAH) and Gandhi Memorial Hospital (GMH). All enrolled women who had a stillbirth or early neonatal death during this period were included as cases and a random sample of women delivering at the hospital was selected to enroll as controls for a 2:1 ratio of controls to cases. Data on potential risk factors were retrieved from medical records including health passports, delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher’s exact test) for quantitative and categorical variables, respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal death.Results: During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. During the study period, hospital records indicated that the estimated stillbirth and neonatal death rates were 30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal death were maternal education (aOR 1.747, 95%CI 1.098-2.780), parity (aOR 1.114, 95%CI .058- 2.484), previous stillbirth (aOR 9.447, 95%CI 6.245-14.289), previous preterm birth (aOR 3.620, 95%CI 2.363-5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228-3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523-7.031).Conclusion: Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services, particularly for women who have a history of obstetric complications identified as risk factors.

scholarly journals Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Guido Grajales-Figueroa ◽  
Héctor Adrián Díaz Hernández ◽  
Martín Alejandro Chacón Portillo ◽  
Luis F. Uscanga ◽  
Mario Peláez-Luna ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Features ◽  
Case Control Study ◽  
Case Control ◽  
Hospitalized Patients ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Infected Necrosis ◽  
Common Etiology ◽  
Control Study

Nosocomial extrapancreatic infections in patients with acute pancreatitis (AP) are associated with a higher mortality even after adjusting the risk for the severity of the pancreatitis. The aim of this study was to describe the clinical features of hospitalized patients with AP who died during their hospitalization and to evaluate risk factors associated with mortality. We performed a descriptive study of the clinical features of adult patients who died from AP during their hospitalization and a case control study with a paired group of patients that survived AP during a 10-year period. Data of interest were collected from the medical records and are presented with appropriate measures of central tendency and dispersion. For the case control study, the primary outcome evaluated was death, and to evaluate associated clinical features and determine differences between groups, we performed the χ2 or Fisher’s exact tests for categorical variables and the Student t-test or Mann-Whitney U test for continuous variables as appropriate. We found 48 patients with acute pancreatitis who died within the period of the study during hospitalization; from these, 50% were men, mean age was 53.2 years, and the most common etiology was biliary obstruction by gallstones in 45.8%. The global mortality rate was of 2.5%. A total of 43.7% patients had infected pancreatic necrosis, and in 58.3%, some extrapancreatic infection was documented, being the most common urinary tract infection in 50%, bacteremia in 50% and pneumonia in 33.3%. Clinical features associated with mortality were the presence of organ failure (p<0.001), nosocomial complications (p<0.001), infected necrosis (p<0.001), and extrapancreatic infections (p=0.002). From the different extrapancreatic infections, only bacteremia (p=0.001) and pneumonia (p=0.011) were associated with higher mortality. In conclusion, extrapancreatic infections are associated with increased mortality among hospitalized patients with acute pancreatitis, in particular, bacteremia and pneumonia with an isolated pathogen.

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