Adverse pregnancy outcomes in rural Uganda (1996–2013): trends and associated factors from serial cross sectional surveys

BMC Pregnancy and Childbirth

Lars Smedman⁴  Anatoli Kamali²  Janet Seeley²  Lena Marions⁴  Rob Newton⁵  Kathy Baisley³  Gershim Asiki¹ 

[1] Medical Research Council/Uganda Virus Research Council, Uganda Research Unit on AIDS, Entebbe, Uganda;London School Hygiene and Tropical Medicine, London, UK;Technical Epidemiological Group, London School Hygiene and Tropical Medicine, London, UK;Department of women’s and children’s Health, Karolinska Institute, Stockholm, Sweden;Department of Health Sciences, University of York, York, UK

关键词: Uganda;    Stillbirth rate;    Abortion rate;    Stillbirth;    Abortion;    Adverse pregnancy outcome;   

Others  :  1232777
DOI  :  10.1186/s12884-015-0708-8

 received in 2015-04-10, accepted in 2015-10-16,  发布年份 2015

【 摘 要 】

Objective

Community based evidence on pregnancy outcomes in rural Africa is lacking yet it is needed to guide maternal and child health interventions. We estimated and compared adverse pregnancy outcomes and associated factors in rural south-western Uganda using two survey methods.

Methods

Within a general population cohort, between 1996 and 2013, women aged 15–49 years were interviewed on their pregnancy outcome in the past 12 months (method 1). During 2012–13, women in the same cohort were interviewed on their lifetime experience of pregnancy outcomes (method 2). Adverse pregnancy outcome was defined as abortions or stillbirths. We used random effects logistic regression for method 1 and negative binomial regression with robust clustered standard errors for method 2 to explore factors associated with adverse outcome.

Results

One third of women reported an adverse pregnancy outcome; 10.8 % (abortion = 8.4 %, stillbirth = 2.4 %) by method 1 and 8.5 % (abortion = 7.2 %, stillbirth = 1.3 %) by method 2. Abortion rates were similar (10.8 vs 10.5) per 1000 women and stillbirth rates differed (26.2 vs 13.8) per 1000 births by methods 1 and 2 respectively. Abortion risk increased with age of mother, non-attendance of antenatal care and proximity to the road. Lifetime stillbirth risk increased with age. Abortion and stillbirth risk reduced with increasing parity.

Discussion

Both methods had a high level of agreement in estimating abortion rate but were markedly below national estimates. Stillbirth rate estimated by method 1 was double that estimated by method 2 but method 1 estimate was more consistent with the national estimates.

Conclusion

Strategies to improve prospective community level data collection to reduce reporting biases are needed to guide maternal health interventions.

【 授权许可】

   
2015 Asiki et al.

【 图 表 】

Fig. 1.

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