Risk factors for adverse outcomes in women with high-risk pregnancy and their neonates, Haiti

Schuurmans, Jorien, Borgundvaag, Emily, Finaldi, Pasquale, Senat-Delva, Rodnie, Desauguste, Fedner, Badjo, Colette, Lekkerkerker, Michiel, Grandpierre, Reynaldo, Lerebours, Gerald, Ariti, Cono and Lenglet, Annick 2021. Risk factors for adverse outcomes in women with high-risk pregnancy and their neonates, Haiti. Pan American Journal of Public Health 45 , e147. 10.26633/RPSP.2021.147

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Abstract

Objectives. To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-) eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales, an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse pregnancy outcomes. Methods. We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services. Results. A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204 (0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%) low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55–6.55) and low birthweight (OR 1.40; 95% CI 1.05–1.86) for women with complicated pregnancies. Conclusion. To prevent and treat pregnancy complications as early as possible, antenatal care attendance is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant women in Haiti is recommended.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL. Open access logo and text by PLoS, under the Creative Commons Attribution-Share Alike 3.0 Unported license
Publisher:	World Health Organization
ISSN:	1020-4989
Date of First Compliant Deposit:	4 January 2022
Date of Acceptance:	21 July 2021
Last Modified:	05 Jan 2022 12:00
URI:	https://orca.cardiff.ac.uk/id/eprint/146361

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