Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach
Complications often arise during pregnancy leading to unfavorable pregnancy outcomes such as stillbirths, abortions/miscarriages, and neonatal losses placing a substantial burden on families, communities, and the health care system. In this study, we estimate pregnancy loss and identify associated f...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-11-01
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| Series: | Global Epidemiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590113320300146 |
| _version_ | 1818846768180232192 |
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| author | Samuel Iddi Damazo T. Kadengye Sylvia Kiwuwa-Muyingo Martin K. Mutua Gershim Asiki |
| author_facet | Samuel Iddi Damazo T. Kadengye Sylvia Kiwuwa-Muyingo Martin K. Mutua Gershim Asiki |
| author_sort | Samuel Iddi |
| collection | DOAJ |
| description | Complications often arise during pregnancy leading to unfavorable pregnancy outcomes such as stillbirths, abortions/miscarriages, and neonatal losses placing a substantial burden on families, communities, and the health care system. In this study, we estimate pregnancy loss and identify associated factors that drive pregnancy loss among women in two urban slums in Nairobi. In order to estimate the population-level effects of risk factors on pregnancy loss, we use the generalized estimation equation (GEE), which also allows us to account for the clustering of deliveries within pregnant women. From 2003 to 2016, the rate of pregnancy loss was 16 per 1000 deliveries (7 per 1000 and 9 per 1000 for stillbirth and miscarriages, respectively). Pregnancy loss was 6% less likely among pregnant women in Viwandani as compared to Korogocho, for a unit increase in years while holding other factors constant [i.e adjusted odds ratio (AOR) of 0.9429, 95% confidence interval (CI) of (0.9006, 0.9872)]. In addition, the study found that for a unit change in gravidity, the odds of experiencing pregnancy loss was 16% less among women in the lowest wealth tertile compared to women in the highest wealth tertile. Also, the odds of pregnancy loss was 6% more for a unit increase in women's age [AOR: 0.8425; 95% CI: (0.7134, 0.9949)]. Currently married and previously married pregnant women were, respectively, thrice and twice more likely to lose pregnancy compared to never-married women [AOR: 3.0180; 95% CI: (1.6930, 5.3798)]. In conclusion, advanced maternal age and being married were found to be strongly associated with the risk of pregnancy loss. The association between pregnancy loss and wealth tertile depends on the level of gravidity of the women. Identification of risk factors associated with pregnancy loss in slum settings can aid in public health programming and designing interventions to ensure safer pregnancy for women. Further research is required to investigate possible hidden factors affecting pregnancy loss for women with higher gravidity in the highest household wealth tertiles. |
| first_indexed | 2024-12-19T05:50:48Z |
| format | Article |
| id | doaj.art-8a91d5cc5e10485e8bed98428bd42d67 |
| institution | Directory Open Access Journal |
| issn | 2590-1133 |
| language | English |
| last_indexed | 2024-12-19T05:50:48Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Global Epidemiology |
| spelling | doaj.art-8a91d5cc5e10485e8bed98428bd42d672022-12-21T20:33:38ZengElsevierGlobal Epidemiology2590-11332020-11-012100030Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approachSamuel Iddi0Damazo T. Kadengye1Sylvia Kiwuwa-Muyingo2Martin K. Mutua3Gershim Asiki4African Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya; Department of Statistics and Actuarial Science, University of Ghana, Accra, Ghana; Corresponding author at: African Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.African Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, KenyaAfrican Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, KenyaAfrican Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, KenyaAfrican Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, KenyaComplications often arise during pregnancy leading to unfavorable pregnancy outcomes such as stillbirths, abortions/miscarriages, and neonatal losses placing a substantial burden on families, communities, and the health care system. In this study, we estimate pregnancy loss and identify associated factors that drive pregnancy loss among women in two urban slums in Nairobi. In order to estimate the population-level effects of risk factors on pregnancy loss, we use the generalized estimation equation (GEE), which also allows us to account for the clustering of deliveries within pregnant women. From 2003 to 2016, the rate of pregnancy loss was 16 per 1000 deliveries (7 per 1000 and 9 per 1000 for stillbirth and miscarriages, respectively). Pregnancy loss was 6% less likely among pregnant women in Viwandani as compared to Korogocho, for a unit increase in years while holding other factors constant [i.e adjusted odds ratio (AOR) of 0.9429, 95% confidence interval (CI) of (0.9006, 0.9872)]. In addition, the study found that for a unit change in gravidity, the odds of experiencing pregnancy loss was 16% less among women in the lowest wealth tertile compared to women in the highest wealth tertile. Also, the odds of pregnancy loss was 6% more for a unit increase in women's age [AOR: 0.8425; 95% CI: (0.7134, 0.9949)]. Currently married and previously married pregnant women were, respectively, thrice and twice more likely to lose pregnancy compared to never-married women [AOR: 3.0180; 95% CI: (1.6930, 5.3798)]. In conclusion, advanced maternal age and being married were found to be strongly associated with the risk of pregnancy loss. The association between pregnancy loss and wealth tertile depends on the level of gravidity of the women. Identification of risk factors associated with pregnancy loss in slum settings can aid in public health programming and designing interventions to ensure safer pregnancy for women. Further research is required to investigate possible hidden factors affecting pregnancy loss for women with higher gravidity in the highest household wealth tertiles.http://www.sciencedirect.com/science/article/pii/S2590113320300146AbortionGeneralized estimation equationsImputationLive birthPregnancy lossRandom forest |
| spellingShingle | Samuel Iddi Damazo T. Kadengye Sylvia Kiwuwa-Muyingo Martin K. Mutua Gershim Asiki Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach Global Epidemiology Abortion Generalized estimation equations Imputation Live birth Pregnancy loss Random forest |
| title | Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach |
| title_full | Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach |
| title_fullStr | Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach |
| title_full_unstemmed | Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach |
| title_short | Associated factors of pregnancy loss in two urban slums of Nairobi: A generalized estimation equations approach |
| title_sort | associated factors of pregnancy loss in two urban slums of nairobi a generalized estimation equations approach |
| topic | Abortion Generalized estimation equations Imputation Live birth Pregnancy loss Random forest |
| url | http://www.sciencedirect.com/science/article/pii/S2590113320300146 |
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