Unfavourable Foetal Pregnancy Outcomes among Primigravida Women in Erbil City of Iraq

Research Article

Austin J Womens Health. 2017; 4(1): 1024.

Unfavourable Foetal Pregnancy Outcomes among Primigravida Women in Erbil City of Iraq

Shahla S Mehedi1, Jawad K Al-Diwan2 and Tariq AL-Hadithi3*

1Directorate of Health of Nineveh, Mosul-Iraq

2Department of Community Medicine, College of Medicine, Baghdad University, Baghdad-Iraq

3Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil- Iraq

*Corresponding author: Tariq AL-Hadithi, Department of Community Medicine, College of Medicine, Baghdad University, Baghdad-Iraq

Received: April 19, 2017; Accepted: June 19, 2017; Published: June 26, 2017

Abstract

Background and Objectives: Pregnancy carries certain health risks for both the women and the infant she bears. This study was done to measure the rates of certain unfavourable foetal pregnancy outcomes among primigravidae and to determine their association with maternal socio-demographic characteristics, pregnancy risk factors and with antenatal care services.

Methods: This cross-sectional study was done on 400 primigravidae women at the labour room of the maternity teaching hospital in Erbil city. Data were collected about three main unfavourable fetal pregnancy outcomes: low birth weight, stillbirth, and preterm delivery. Data collection was carried out through direct interview with women using especially designed questionnaire.

Results: The rates of the low birth weight, stillbirth, and preterm delivery were: 5.9%, 1.8%, and 8.8%, respectively. Low birth weight was associated with lower maternal education (P=0.009), increased psychosocial stress (P=0.023), lower number of antenatal care visits (P<0.001), late first antenatal care visit (P=0.015), ferrofolic supplementation (P=0.011), anaemia (P<0.001), and lower gestational age (P<0.001). Stillbirth was associated with lower number of antenatal care visits (P=0.005) and lower gestational age (P<0.001). Preterm delivery was associated with increased psychosocial stress (P=0.006), lower number of antenatal care visits (P<0.001), anaemia (P=0.001) and low birth weight (P<0.001).

Conclusion: The rates of unfavourable foetal pregnancy outcomes in primigravida women are within the range of those reported in other parts of Iraq and neighboring countries, with inconsistency in the risk factors associated with various unfavourable foetal pregnancy outcomes.

Introduction

Pregnancy outcome as a measure of the health status of both the infant and mother is influenced by several factors, which may include poor nutrition of the women, child spacing, maternal age (less than 15 years and over 35 years) and inadequate prenatal care [1]. Other factors include life behaviours (e.g. smoking, alcohol consumption, drug abuse and unsafe sex), overweight, obesity and poverty [2,3].

Primiparity has been found to be associated with significantly higher incidence of adverse pregnancy foetal and maternal outcomes in several studies [4-6]. Studying of the association of certain independent factors including socio-demographic characteristics of pregnant women, pregnancy risk factors and Antenatal Care (ANC) services with the occurrence of adverse pregnancy outcomes in primigravidae is, therefore, of extreme importance in early detection and prevention of such undesirable adverse pregnancy outcomes among pregnant women. Unfortunately, no sufficient attention has been given to this aspect of women’s health and no published study has tackled the problem in Erbil city.

The purpose of this study was to measure the rates of the main unfavourable fetal outcomes among a sample of primigravida women and determine their association with maternal socio-demographic characteristics and pregnancy risk factors and with provision of ANC services.

Patients and Methods

A cross-sectional study was conducted at the maternity teaching hospital in Erbil city, the capital of Kurdistan region of Iraq, between 1st of July, 2015 and 30th of June, 2016. A convenience sample of 400 primigravida women was collected. Primigravida women more than 24 weeks of gestational age attending the labour room during the study period were included in the study. Women with chronic disease like diabetes mellitus, hypertension, bronchial asthma, renal disease, cardiovascular disease and women had multiple pregnancy or pre-eclampsia were excluded.

A detailed structured especially designed questionnaire was used to obtain relevant data. Data were obtained from primigravida women by direct interview in the labour room or post labour wards of hospital. A detailed history was obtained from each women together with physical examination. Blood samples were sent for Hb level. Ultrasound was used to ensure viability of the foetus, and gestational age.

Pregnancy foetal outcomes such as preterm (babies born before the end of 37 weeks gestation) [7], LBW (live infant weighting ‹ 2500 g at birth) [8], stillbirth (any fetus born with no sign of life after 24 weeks of gestation) [9] were taken as dependent variables. The study comprises a set of independent variables including age and educational level of mother, psychosocial stress, and ANC, anemia and ferrofolic supplementation during current pregnancy.