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Frequency, risk factors and feto-maternal outcomes of abruptio placentae in Northern Tanzania: a registry-based retrospective cohort study.
Macheku, Godwin S; Philemon, Rune Nathaniel; Oneko, Olola; Mlay, Pendo S; Masenga, Gileard; Obure, Joseph; Mahande, Michael Johnson.
Afiliação
  • Macheku GS; Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical Collage (KCM College), Moshi, Tanzania. machekusg@yahoo.com.
  • Philemon RN; Department of Paediatrics, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical Collage (KCM College), Moshi, Tanzania. rphilemon@yahoo.co.uk.
  • Oneko O; Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical Collage (KCM College), Moshi, Tanzania. ololaoneko03@gmail.com.
  • Mlay PS; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, 2240, Moshi, Tanzania. ololaoneko03@gmail.com.
  • Masenga G; Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical Collage (KCM College), Moshi, Tanzania. pendomlay1975@gmail.com.
  • Obure J; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, 2240, Moshi, Tanzania. pendomlay1975@gmail.com.
  • Mahande MJ; Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical Collage (KCM College), Moshi, Tanzania. drgmasenga@yahoo.com.
BMC Pregnancy Childbirth ; 15: 242, 2015 Oct 07.
Article em En | MEDLINE | ID: mdl-26446879
BACKGROUND: Abruptio placentae remains a major cause of maternal and perinatal morbidity and mortality in developing countries. Little is known about the burden of abruptio placentae in Tanzania. This study aimed to determine frequency, risk factors for abruptio placentae and subsequent feto-maternal outcomes in women with abruptio placentae. METHODS: We designed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry. Data on all women who delivered live infants and stillbirths at 28 or more weeks of gestation at KCMC hospital from July 2000 to December 2010 (n = 39,993) were analysed. Multivariate logistic models were used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for risk factors, and feto-maternal outcomes associated with abruptio placentae. RESULTS: The frequency of abruptio placentae was 0.3% (112/39,993). Risk factors for abruptio placentae were chronic hypertension (OR 4.1; 95% CI 1.3-12.8), preeclampsia/eclampsia (OR 2.1; 95% CI 1.1-4.1), previous caesarean delivery (OR 1.3; 95% CI 1.2-4.2), previous abruptio placentae (OR 2.3; 95% CI 1.8-3.4), fewer antenatal care visits (OR 1.3; 95% 1.1-2.4) and high parity (OR 1.4; 95% CI 1.2-8.6). Maternal complications associated with abruptio placentae were antepartum haemorrhage (OR 11.5; 95% CI 6.3-21.2), postpartum haemorrhage (OR 17.9; 95% 8.8-36.4),), caesarean delivery (OR 5.6; 95% CI 3.6-8.8), need for blood transfusions (OR 9.6; 95% CI 6.5-14.1), altered liver function (OR 5.3; 95% CI 1.3-21.6) and maternal death (OR 1.6; 95% CI 1.5-1.8). In addition, women with abruptio placentae had prolonged duration of hospital stay (more than 4 days) and were more likely to have been referred during labour. Adverse fetal outcomes associated with abruptio placentae include low birth weight (OR 5.9; 95% CI 3.9-8.7), perinatal death (OR 17.6; 95% CI 11.3-27.3) and low Apgar score (below 7) at 1 and 5 min. CONCLUSIONS: Frequency of abruptio placentae is comparable with local and international studies. Chronic hypertension, preeclampsia, prior caesarean section delivery, prior abruptio placentae, poor attendance to antenatal care and high parity were independently associated with abruptio placentae. Abruptio placentae was associated with adverse maternal and foetal outcomes. Clinicians should identify risk factors for abruptio placentae during prenatal care when managing pregnant women to prevent adverse maternal and foetal outcomes.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Recém-Nascido de Baixo Peso / Países em Desenvolvimento / Descolamento Prematuro da Placenta / Morte Perinatal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Assunto da revista: OBSTETRICIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Tanzânia

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Recém-Nascido de Baixo Peso / Países em Desenvolvimento / Descolamento Prematuro da Placenta / Morte Perinatal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Assunto da revista: OBSTETRICIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Tanzânia