Annual distribution of births and deaths outcomes at Harare Maternity Hospital, Zimbabwe

An assessement of socio-demographic and reproductive/obstetric risk factors for stillbirth, preterm births and low birth weight (LBW). The article also aims to explore the probability of death at birth by antenatal care attendance, and by delivery with a Caesarean section in a Zimbabwe referral hospital.Information on frequency and distribution of adverse birth outcomes is important for planning of maternal Introduction and child health care services world-wide, and knowledge of local patterns of morbidity and mortality is essential for improving antenatal and obstetric care. Perinatal mortality remains a challenge in the care of pregnant women worldwide, particularly in developing countries. Stillbirths, who form the highest number of perinatal deaths, are both common and devastating, and in developed countries, about one third has been shown to be of unknown or unexplained origin. The stillbirth rate is an important indicator of the quality of antenatal and obstetric care. Understanding the distribution of stillbirths helps to identify the quality of antenatal and obstetric care available to the pregnant women and to prioritize intervention strategies appropriately. Few studies from Zimbabwe'" have examined frequency of perinatal mortality and how this outcome varies across important demographic subgroups

Improving the assessment of gestational age in a Zimbabwean population

Objectives: To evaluate the performance and the utility of using birthweight‐adjusted scores of Dubowitz and Ballard methods of estimating gestational age in a Zimbabwean population. Method: The Dubowitz and the Ballard methods of estimating gestational age were administered to 364 African newborn infants with a known last menstrual period (LMP) at Harare Maternity Hospital. Results: Both methods were good predictors of gestational age useful in differentiating term from pre‐term infants. Our regression line was Y(LMP gestational age)=23.814+0.301*score for the Dubowitz and Y(LMP gestational age)=24.493+0.420*score for the Ballard method. Addition of birthweight to the regression models improved prediction of gestational age; Y(LMP gestational age)=23.512+0.219*score+0.0015*grams for Dubowitz and Y(LMP gestational age)=24.002+0.292*score+0.0016*grams for Ballard method. Conclusions: We recommend the use of our birthweight‐adjusted maturity scales; the Dubowitz for studies of prematurity, and the Ballard for routine clinical practice.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135611/1/ijgo7.pd

Predictors and outcomes of low birth weight in Lusaka, Zambia

OBJECTIVE: To determine factors associated with low birth weight (LBW) in an urban Zambian cohort and investigate risk of adverse outcomes for LBW neonates. METHODS: The present retrospective cohort analysis used data recorded between February 2006 and December 2012 for singletons and first-born twins delivered in the public health system of Lusaka, Zambia. Routine clinical data and generalized estimating equations were used to examine covariates associated with LBW (<2500 g) and describe outcomes of LBW. RESULTS: In total, 200 557 neonates were included, 21 125 (10.5%) of whom had LBW. Placental abruption, delivery before 37 weeks, and twin pregnancy were associated with LBW in multivariable analysis (P<0.01 for all). Compared with neonates weighing more than 2500 g, those with LBW were at higher risk of stillbirth (adjusted odds ratio [AOR] 8.6, 95% confidence interval [CI] 6.5–11.5), low Apgar score (AOR 5.7, 95% CI 4.6–7.2), admission to the neonatal intensive care unit (AOR 5.4, 95% CI 3.5–8.3), and very early neonatal death (AOR 6.2, 95% CI 3.7–10.3). CONCLUSION: LBW neonates are at increased risk of adverse outcomes, including stillbirth and neonatal death, independent of pregnancy duration at delivery and multiple pregnancy. These findings underscore the need for early, comprehensive, and high-quality prenatal care