Dataset Information

Effects of inter-pregnancy intervals on preterm birth, low birth weight and perinatal deaths in urban South Ethiopia: a prospective cohort study.

ABSTRACT:

Background

Preterm birth, low birth weight and perinatal deaths are common adverse perinatal outcomes that are linked with each other, and a public health problems contributing to neonatal mortality, especially in developing countries. Although more than half of women in Ethiopia become pregnant within a short interval after the preceding childbirth, whether the short intervals increase the risk of adverse perinatal outcomes or not is understudied. We, therefore, aimed to assess the effects of inter-pregnancy intervals (IPIs) on the adverse perinatal outcomes.

Methods

A community-based prospective cohort study was conducted among 2578 pregnant women in urban South Ethiopia. Pregnant women with IPIs < 24 months (IPIs < 18 and 18-23 months) were exposed groups, and those with IPI 24-60 months were the unexposed group. A multilevel analysis (mixed-effects) was done to estimate the effect of IPIs on preterm birth and low birth weight, and a generalized linear model for a binary outcome (fixed-effect) was done for perinatal deaths, using a 95% confidence level.

Results

In this study, IPI < 18 months found to increase the risk of preterm birth (Adjusted Relative Risk (ARR) = 1.35, 95% CI: 1.02, 1.78), term low birth weight (ARR = 2.20, 95% CI: 1.35, 3.58) and perinatal deaths (ARR = 3.83, 95% CI: 1.90, 7.71) than 24-60 months. The results suggest that, about 9% of preterm birth, 21% of term low birth weight and 41% of perinatal deaths in the study population were attributed to IPI < 18 months. These could be prevented with the removal of the IPI < 18 months in the study population. IPI 18-23 months has shown no effect on the three adverse perinatal outcomes.

Conclusion

This study has shown that, IPI under 18 months has a higher risk of adverse perinatal outcomes than IPI 24-60 months. Due attention should still be given for spacing pregnancies.

SUBMITTER: Jena BH

PROVIDER: S-EPMC9092840 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Effects of inter-pregnancy intervals on preterm birth, low birth weight and perinatal deaths in urban South Ethiopia: a prospective cohort study.

Jena Belayneh Hamdela BH Biks Gashaw Andargie GA Gete Yigzaw Kebede YK Gelaye Kassahun Alemu KA

Maternal health, neonatology and perinatology 20220511 1

<h4>Background</h4>Preterm birth, low birth weight and perinatal deaths are common adverse perinatal outcomes that are linked with each other, and a public health problems contributing to neonatal mortality, especially in developing countries. Although more than half of women in Ethiopia become pregnant within a short interval after the preceding childbirth, whether the short intervals increase the risk of adverse perinatal outcomes or not is understudied. We, therefore, aimed to assess the effe ...[more]

PMID: 35545779

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Project description:BackgroundAnemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia.MethodsThis review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed.ResultsThere were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW.ConclusionThe findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB.

Project description:IntroductionMaternal and child mortality remains a major public health concern in Ethiopia. Improving the practice of short inter-pregnancy intervals is a key strategy to reduce neonatal and maternal mortality. Several primary studies conducted in Ethiopia have revealed the practice short inter-pregnancy interval. However, inconsistencies among these studies have been observed, and no review has been conducted to report the combined magnitude, determinants, and complications. Therefore, this review aims to estimate the national magnitude, determinants, and complications of short inter-pregnancy intervals among pregnant mothers in Ethiopia.MethodsFollowing the PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar that investigated the magnitude, determinants, and complications of a short inter-pregnancy interval. The Q and I2 tests were used to assess heterogeneity across studies. We utilized a weighted inverse variance random effects model to evaluate the national magnitude and effect size of linked covariates. To examine publication bias, we employed a funnel plot and Egger's regression test. A sensitivity analysis was also performed to determine the impact of the studies.ResultsThe analysis included a total of twenty-six studies. The pooled magnitude of a short inter-pregnancy interval in Ethiopia was found to be 44.054% (95% CI 32.735-55.372; I2 = 100%; P < 0.001). no formal education (AOR = 1.889; 95% CI 1.261-2.517; I2 = 3.42%; P = 0.41), never used contraceptive methods (AOR = 3.38; 95% CI 2.41-4.35; I2 = 44.9%; P = 0.027), breastfeeding duration of less than 24 months (AOR = 6.69; 95% CI 4.77-8.52; I2 = 95.5%; P = 0.00), having a preceding female child (AOR = 1.45; 95% CI 0.88-2.015; I2 = 16.4%; P = 0.301), and experiencing fetal complication (AOR = 3.55; 95% CI 1.986-5.122; I2 = 0%; P = 0.482).ConclusionA substantial number of women in Ethiopia continue to have a short inter-pregnancy interval. To address this issue, it is crucial to focus on empowering women through education and raising awareness about the importance of spacing pregnancies adequately. Efforts should be made to improve breastfeeding practices, promoting the recommended duration of at least 24 months.

Project description:BackgroundPreterm birth is a disease of multifactorial etiologies that has environmental, social, and maternal health components. Individual studies have shown that exposure to arsenic contaminated drinking water, child marriage, and low maternal weight gain during pregnancy contribute to preterm birth. These factors are highly prevalent and often co-exist in Bangladesh, a country in South Asia with one of the world's highest prevalences of preterm birth.ObjectiveTo evaluate the individual and interactive effects of prenatal arsenic exposure, child marriage, and pregnancy weight gain on preterm birth in a prospective birth cohort in Bangladesh.MethodsDuring 2008-2011, we recruited 1613 pregnant women aged ≥18years at ≤16weeks of gestation and followed them until 1-month post-partum. We measured total arsenic in drinking water (n=1184) and in maternal toenails (n=1115) collected at enrollment and ≤1-month post-partum, respectively using inductively coupled plasma mass spectrometry. Child marriage (<18years old) was defined using self-report, and 2nd and 3rd trimester pregnancy weight gain was calculated using monthly records. Gestational age was determined at enrollment by ultrasound.ResultsIn multivariate adjusted Poisson regression models, the risk ratios (RR) for preterm birth were 1.12 (95% CI: 1.07-1.18) for a unit change in natural log water arsenic exposure, 2.28 (95% CI: 1.76-2.95) for child marriage, and 0.64 (95% CI: 0.42-0.97) for a pound per week increase in maternal weight during the 2nd and 3rd trimesters. In stratified analysis by child marriage, pregnancy weight gain was inversely associated with preterm birth among women with a history of child marriage (RR=0.58; 95% CI: 0.37-0.92), but not among women with no history of child marriage (RR=86; 95% CI: 0.37-2.01). Mediation analysis revealed that both arsenic exposure and child marriage had small but significant associations with preterm birth via lowering pregnancy weight gain. Similar associations were observed when arsenic exposure was assessed using maternal toenail arsenic concentrations.ConclusionsReducing arsenic exposure and ending child marriage could reduce the risk of preterm birth in Bangladesh. Furthermore, enhancing nutritional support to ensure adequate weight gain during pregnancy may provide additional benefits especially for women with a history of child marriage.

Dataset Information

Effects of inter-pregnancy intervals on preterm birth, low birth weight and perinatal deaths in urban South Ethiopia: a prospective cohort study.

Background

Methods

Results

Conclusion

Publications

Effects of inter-pregnancy intervals on preterm birth, low birth weight and perinatal deaths in urban South Ethiopia: a prospective cohort study.

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