Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname
Abstract Background Adequate antenatal care (ANC) services are key for early identification of pregnancy related risk factors and maintaining women’s health during pregnancy. This study aimed to assess the influence of ANC provided by the Medical Mission Primary Health Care Suriname (MMPHCS) and of...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03364-2 |
| _version_ | 1811295297903525888 |
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| author | G. K. Baldewsingh B. C. Jubitana E. D. van Eer A. Shankar A. D. Hindori-Mohangoo H. H. Covert L. Shi M. Y. Lichtveld C. W. R. Zijlmans |
| author_facet | G. K. Baldewsingh B. C. Jubitana E. D. van Eer A. Shankar A. D. Hindori-Mohangoo H. H. Covert L. Shi M. Y. Lichtveld C. W. R. Zijlmans |
| author_sort | G. K. Baldewsingh |
| collection | DOAJ |
| description | Abstract Background Adequate antenatal care (ANC) services are key for early identification of pregnancy related risk factors and maintaining women’s health during pregnancy. This study aimed to assess the influence of ANC provided by the Medical Mission Primary Health Care Suriname (MMPHCS) and of ethnicity on adverse birth outcomes in Tribal and Indigenous women living in Suriname’s remote tropical rainforest interior. Method From April 2017 to December 2018 eligible Tribal and Indigenous women with a singleton pregnancy that received ANC from MMPHCS were included in the study. Data on low birth weight (LBW < 2500 g), preterm birth (PTB < 37 weeks), low Apgar score (< 7 at 5 min), parity (≤1 vs. > 1) and antenatal visits utilization (≥8 vs. < 8) in 15 interior communities were retrospectively analyzed using descriptive statistics, crosstabs and Fisher’s exact tests. Results A total of 204 women were included, 100 (49%) were Tribal, mean age was 26 ± 7.2 years and 126 women (62%) had 8 or more ANC visits. One participant had a miscarriage; 22% had adverse birth outcomes: 16 (7.9%) LBW and 30 (14.8%) PTB; 7 women had a child with both PTB and LBW; 5 women had stillbirths. None of the newborns had low Apgar scores. Maternal age, ethnicity, ANC and parity were associated with PTB (χ2 = 8,75, p = 0.003, χ2 = 4,97, p = 0.025, χ2 = 17,45, p < 0.001, χ2 = 11,93, p < 0.001 respectively). Conclusion Despite an almost 100% study adherence over one fifth of women that received ANC in the interior of Suriname had adverse birth outcomes, in particular PTB and LBW. Younger nulliparous Indigenous women with less than the recommended 8 ANC visits had a higher risk for PTB. The rate of adverse birth outcomes highlights the need for further research to better assess factors influencing perinatal outcomes and to put strategies in place to improve perinatal outcomes. Exposure assessment of this sub-cohort and neurodevelopment testing of their children is ongoing and will further inform on potential adverse health effects associated with environmental exposures including heavy metals such as mercury and lead. |
| first_indexed | 2024-04-13T05:30:14Z |
| format | Article |
| id | doaj.art-678078452ba64f5cb72241f7d6c68834 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T05:30:14Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-678078452ba64f5cb72241f7d6c688342022-12-22T03:00:27ZengBMCBMC Pregnancy and Childbirth1471-23932020-11-012011910.1186/s12884-020-03364-2Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of SurinameG. K. Baldewsingh0B. C. Jubitana1E. D. van Eer2A. Shankar3A. D. Hindori-Mohangoo4H. H. Covert5L. Shi6M. Y. Lichtveld7C. W. R. Zijlmans8Medical Mission Primary Health Care SurinameMedical Mission Primary Health Care SurinameMedical Mission Primary Health Care SurinameTulane University School of Public Health and Tropical MedicineTulane University School of Public Health and Tropical MedicineTulane University School of Public Health and Tropical MedicineTulane University School of Public Health and Tropical MedicineTulane University School of Public Health and Tropical MedicineFaculty of Medical Sciences, Anton de Kom University of SurinameAbstract Background Adequate antenatal care (ANC) services are key for early identification of pregnancy related risk factors and maintaining women’s health during pregnancy. This study aimed to assess the influence of ANC provided by the Medical Mission Primary Health Care Suriname (MMPHCS) and of ethnicity on adverse birth outcomes in Tribal and Indigenous women living in Suriname’s remote tropical rainforest interior. Method From April 2017 to December 2018 eligible Tribal and Indigenous women with a singleton pregnancy that received ANC from MMPHCS were included in the study. Data on low birth weight (LBW < 2500 g), preterm birth (PTB < 37 weeks), low Apgar score (< 7 at 5 min), parity (≤1 vs. > 1) and antenatal visits utilization (≥8 vs. < 8) in 15 interior communities were retrospectively analyzed using descriptive statistics, crosstabs and Fisher’s exact tests. Results A total of 204 women were included, 100 (49%) were Tribal, mean age was 26 ± 7.2 years and 126 women (62%) had 8 or more ANC visits. One participant had a miscarriage; 22% had adverse birth outcomes: 16 (7.9%) LBW and 30 (14.8%) PTB; 7 women had a child with both PTB and LBW; 5 women had stillbirths. None of the newborns had low Apgar scores. Maternal age, ethnicity, ANC and parity were associated with PTB (χ2 = 8,75, p = 0.003, χ2 = 4,97, p = 0.025, χ2 = 17,45, p < 0.001, χ2 = 11,93, p < 0.001 respectively). Conclusion Despite an almost 100% study adherence over one fifth of women that received ANC in the interior of Suriname had adverse birth outcomes, in particular PTB and LBW. Younger nulliparous Indigenous women with less than the recommended 8 ANC visits had a higher risk for PTB. The rate of adverse birth outcomes highlights the need for further research to better assess factors influencing perinatal outcomes and to put strategies in place to improve perinatal outcomes. Exposure assessment of this sub-cohort and neurodevelopment testing of their children is ongoing and will further inform on potential adverse health effects associated with environmental exposures including heavy metals such as mercury and lead.http://link.springer.com/article/10.1186/s12884-020-03364-2Antenatal care utilization and contentBirth outcomesIndigenousTribalSuriname |
| spellingShingle | G. K. Baldewsingh B. C. Jubitana E. D. van Eer A. Shankar A. D. Hindori-Mohangoo H. H. Covert L. Shi M. Y. Lichtveld C. W. R. Zijlmans Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname BMC Pregnancy and Childbirth Antenatal care utilization and content Birth outcomes Indigenous Tribal Suriname |
| title | Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname |
| title_full | Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname |
| title_fullStr | Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname |
| title_full_unstemmed | Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname |
| title_short | Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname |
| title_sort | adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of suriname |
| topic | Antenatal care utilization and content Birth outcomes Indigenous Tribal Suriname |
| url | http://link.springer.com/article/10.1186/s12884-020-03364-2 |
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