Artikel
Risk factors for unfavourable birth outcome in the Sub-Saharan African Country of Gabon
Risikofaktoren für niedriges Geburtsgewicht in zwei Gebutskliniken in Gabun, Zentral-Afrika
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Autoren
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F. Kurth
- Medical Research Unit of the Albert Schweitzer Hospital, Lambaréné, Gabon; University Hospital Carl Gustav Carus, Department of Neonatology and Paediatric Intensive Care, Dresden, Germany; Institute of Tropical Medicine, University of Tübingen, Germany
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S. Bélard
- Medical Research Unit of the Albert Schweitzer Hospital, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Germany; Department of Paediatrics and Adolscent Medicine, University of Freiburg, Germany
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P.G. Kremsner
- Medical Research Unit of the Albert Schweitzer Hospital, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Germany
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M. Ramharter
- Medical Research Unit of the Albert Schweitzer Hospital, Lambaréné, Gabon; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria
| Veröffentlicht: | 2. Juni 2010 |
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Gliederung
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Objectives: In Gabon, a region of high perennial transmission of P. falciparum, national policy for prevention of malaria in pregnancy is intermittent preventive treatment (IPTp) with Sulfadoxine-Pyrimethamine (SP) and use of impregnated bednets. Malaria is thought to be a major cause for premature birth and low birth weight in this region. The present analysis aimed to evaluate risk factors for unfavourable birth outcomes in pregnant women.
Methods: This cross sectional epidemiological survey was performed in 1,014 women delivering at the obstetric departments of two local hospitals in the cities of Libreville and Lambaréné in Gabon, Central Africa. All newborns were weighted immediately after birth and information on demographic data, the course of pregnancy and antenatal consultations was collected through an interview and from mother-child health booklets. A thick blood smear was performed in a subgroup of delivering women.
Results: Young maternal age (≤vs. >16) and a lower number of antenatal consultations (≤3 vs. >3) were the most important risk factors for delivery of a low birth weight (LBW) baby. These factors had more influence on birth outcome than intake of SP, the use of insecticide treated bednets or peripheral parasitaemia at delivery (see Table 1 [Tab. 1]).
The proportion of teenage mothers with an age ≤16 years who delivered a low birth weight baby was more than 2 times higher than in women older than 16 years (22.8% vs. 9.3%). According to that, birthweight of children born to teenage mothers was on average 304g lower than of children born to adult mothers (2795±514g versus 3099±493g p<0.0001, n=775).
Conclusion: Our data indicate that young maternal age (≤16 years) and few antenatal consultations (≤3) were more important risk factors for unfavourable birth outcome than infectious diseases including a thick blood smear positive for falciparum malaria, non-adherence to IPTp or lack of bednet-use in Gabonese women.
