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Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry‐based cohort study
Author(s) -
Mahande Michael J.,
Daltveit Anne K.,
Obure Joseph,
Mmbaga Blandina T.,
Masenga Gileard,
Magi Rachel,
Lie Rolv T.
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12111
Subject(s) - medicine , obstetrics , tanzania , pregnancy , cohort study , confounding , premature birth , pediatrics , prospective cohort study , gestational age , surgery , genetics , environmental science , environmental planning , pathology , biology
Objectives To estimate the recurrence risk of preterm delivery and estimate the perinatal mortality in repeated preterm deliveries. Methods Prospective 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. Results For 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%. Conclusion Previous 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.