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Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study

BACKGROUND: Newborns with one-or-more adverse birth outcomes (ABOs) are at greater risk of mortality or long-term morbidity with health impacts into adulthood. Hence, identifying ABO-associated factors is crucial for devising relevant interventions. For this study, ABOs were defined as prematurity (...

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Autores principales: Vasconcelos, Alexandra, Sousa, Swasilanne, Bandeira, Nelson, Alves, Marta, Papoila, Ana Luísa, Pereira, Filomena, Machado, Maria Céu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328319/
https://www.ncbi.nlm.nih.gov/pubmed/37418369
http://dx.doi.org/10.1371/journal.pone.0276348
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author Vasconcelos, Alexandra
Sousa, Swasilanne
Bandeira, Nelson
Alves, Marta
Papoila, Ana Luísa
Pereira, Filomena
Machado, Maria Céu
author_facet Vasconcelos, Alexandra
Sousa, Swasilanne
Bandeira, Nelson
Alves, Marta
Papoila, Ana Luísa
Pereira, Filomena
Machado, Maria Céu
author_sort Vasconcelos, Alexandra
collection PubMed
description BACKGROUND: Newborns with one-or-more adverse birth outcomes (ABOs) are at greater risk of mortality or long-term morbidity with health impacts into adulthood. Hence, identifying ABO-associated factors is crucial for devising relevant interventions. For this study, ABOs were defined as prematurity (PTB) for gestational age <37 weeks, low birth weight (LBW) <2.5 kg, macrosomia >4 kg, asphyxia for a 5-minute Apgar score <7, congenital anomalies, and neonatal sepsis. This study aimed to assess factors associated with ABOs among babies delivered at the only hospital of Sao Tome & Principe (STP), a resource-constrained sub-Saharan-Central African country. METHODS: A hospital-based unmatched case‒control study was conducted among newborns from randomly selected mothers. Newborns with one-or-more ABO were the cases (ABO group), while healthy newborns were the controls (no-ABO group). Data were collected by a face-to-face interview and abstracted from antenatal care (ANC) pregnancy cards and medical records. Multivariable logistic regression analysis was performed to identify ABO-associated factors considering a level of significance of α = 0.05. RESULTS: A total of 519 newborns (176 with ABO and 343 no-ABO) were enrolled. The mean gestational age and birthweight of cases and controls were 36 (SD = 3.7) weeks with 2659 (SD = 881.44) g and 39.6 (SD = 1.0) weeks with 3256 (SD = 345.83) g, respectively. In the multivariable analysis, twin pregnancy [aOR 4.92, 95% CI 2.25–10.74], prolonged rupture of membranes [aOR 3.43, 95% CI 1.69–6.95], and meconium- fluid [aOR 1.59, 95% CI 0.97–2.62] were significantly associated with ABOs. Eight or more ANC contacts were found to be protective [aOR 0.33, 95% CI 0.18–0.60, p<0.001]. CONCLUSION: Modifiable factors were associated with ABOs in this study and should be considered in cost-effective interventions. The provision of high-quality ANC should be a priority. Twin pregnancies and intrapartum factors such as prolonged rupture of membranes and meconium-stained amniotic fluid are red flags for ABOs that should receive prompt intervention and follow-up.
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spelling pubmed-103283192023-07-08 Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study Vasconcelos, Alexandra Sousa, Swasilanne Bandeira, Nelson Alves, Marta Papoila, Ana Luísa Pereira, Filomena Machado, Maria Céu PLoS One Research Article BACKGROUND: Newborns with one-or-more adverse birth outcomes (ABOs) are at greater risk of mortality or long-term morbidity with health impacts into adulthood. Hence, identifying ABO-associated factors is crucial for devising relevant interventions. For this study, ABOs were defined as prematurity (PTB) for gestational age <37 weeks, low birth weight (LBW) <2.5 kg, macrosomia >4 kg, asphyxia for a 5-minute Apgar score <7, congenital anomalies, and neonatal sepsis. This study aimed to assess factors associated with ABOs among babies delivered at the only hospital of Sao Tome & Principe (STP), a resource-constrained sub-Saharan-Central African country. METHODS: A hospital-based unmatched case‒control study was conducted among newborns from randomly selected mothers. Newborns with one-or-more ABO were the cases (ABO group), while healthy newborns were the controls (no-ABO group). Data were collected by a face-to-face interview and abstracted from antenatal care (ANC) pregnancy cards and medical records. Multivariable logistic regression analysis was performed to identify ABO-associated factors considering a level of significance of α = 0.05. RESULTS: A total of 519 newborns (176 with ABO and 343 no-ABO) were enrolled. The mean gestational age and birthweight of cases and controls were 36 (SD = 3.7) weeks with 2659 (SD = 881.44) g and 39.6 (SD = 1.0) weeks with 3256 (SD = 345.83) g, respectively. In the multivariable analysis, twin pregnancy [aOR 4.92, 95% CI 2.25–10.74], prolonged rupture of membranes [aOR 3.43, 95% CI 1.69–6.95], and meconium- fluid [aOR 1.59, 95% CI 0.97–2.62] were significantly associated with ABOs. Eight or more ANC contacts were found to be protective [aOR 0.33, 95% CI 0.18–0.60, p<0.001]. CONCLUSION: Modifiable factors were associated with ABOs in this study and should be considered in cost-effective interventions. The provision of high-quality ANC should be a priority. Twin pregnancies and intrapartum factors such as prolonged rupture of membranes and meconium-stained amniotic fluid are red flags for ABOs that should receive prompt intervention and follow-up. Public Library of Science 2023-07-07 /pmc/articles/PMC10328319/ /pubmed/37418369 http://dx.doi.org/10.1371/journal.pone.0276348 Text en © 2023 Vasconcelos et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Vasconcelos, Alexandra
Sousa, Swasilanne
Bandeira, Nelson
Alves, Marta
Papoila, Ana Luísa
Pereira, Filomena
Machado, Maria Céu
Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title_full Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title_fullStr Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title_full_unstemmed Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title_short Adverse birth outcomes and associated factors among newborns delivered in Sao Tome & Principe: A case‒control study
title_sort adverse birth outcomes and associated factors among newborns delivered in sao tome & principe: a case‒control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328319/
https://www.ncbi.nlm.nih.gov/pubmed/37418369
http://dx.doi.org/10.1371/journal.pone.0276348
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