Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry-based cohort study.

Michael J Mahande,Rolv T Lie,Joseph Obure,Rachel Manongi,Blandina T Mmbaga,Gileard Masenga,Anne K Daltveit

doi:10.1111/tmi.12111

Abstract

ObjectivesTo estimate the recurrence risk of preterm delivery and estimate the perinatal mortality in repeated preterm deliveries.MethodsProspective study in Tanzania of 18 176 women who delivered a singleton between 2000 and 2008 at KCMC hospital. The women were followed up to 2010 for consecutive births. A total of 3359 women were identified with a total of 3867 subsequent deliveries in the follow-up period. Recurrence risk of preterm birth and perinatal mortality was estimated using log-binomial regression and adjusted for potential confounders.ResultsFor women with a previous preterm birth, the risk of preterm birth in a subsequent pregnancy was 17%. This recurrence risk was estimated to be 2.7-fold (95% CI: 2.1–3.4) of the risk of women with a previous term birth. The perinatal mortality of babies in a second preterm birth of the same woman was 15%. Babies born at term who had an older sibling that was born preterm had a perinatal mortality of 10%. Babies born at term who had an older sibling who was also born at term had a perinatal mortality of 1.7%.ConclusionPrevious delivery of a preterm infant is a strong predictor of future preterm births in Tanzania. Previous or repeated preterm births increase the risk of perinatal death substantially in the subsequent pregnancy.

Highlights

Preterm birth is a major cause of morbidity and mortality among newborns and is estimated to account for 28% of neonatal mortality in the world each year (Lawn et al 2010). World Health Organization (2012) estimates that around 15 million babies are born preterm each year, the majority in low-income countries
This study was conducted at Kilimanjaro Christian Medical Centre (KCMC), one of the four zone referral hospitals in Tanzania located in Moshi urban district, of the Kilimanjaro region in northern Tanzania
Women with prior preterm birth had a 2.7-fold increased risk of preterm birth in their subsequent pregnancies compared with women who delivered an infant at term in the first pregnancy

Summary

Introduction

Preterm birth is a major cause of morbidity and mortality among newborns and is estimated to account for 28% of neonatal mortality in the world each year (Lawn et al 2010). World Health Organization (2012) estimates that around 15 million babies are born preterm each year, the majority in low-income countries. Preterm birth is a major cause of morbidity and mortality among newborns and is estimated to account for 28% of neonatal mortality in the world each year (Lawn et al 2010). World Health Organization (2012) estimates that around 15 million babies are born preterm each year, the majority in low-income countries. Studies in Tanzania have reported prevalences between 10% and 16.7% (Fawzi et al 2007; Habib et al 2011). This is about twice as high as the figures reported in high-income countries (Lawn et al 2010). There is a strong association between preterm birth and perinatal mortality in Africa (Kinney et al 2010)

Methods

Results

Discussion

Conclusion