Recurrence of adverse pregnancy outcomes in Tanzania
Michael Johnson Mahande presents his dissertation on Thursday February 19th 2015 for PhD at the University of Bergen. Title: "Recurrence of Perinatal death, Preterm birth and Preeclampsia in Northern Tanzania: A Registry Based Study"
Some women carry a high risk of adverse pregnancy outcomes. This is reflected in a tendency of these women to repeat outcomes in successive pregnancies. This may be estimated by the recurrence risk. Recurrence risks are well described in high-income countries for several adverse pregnancy outcomes. Little is known about the recurrence risk of pregnancy outcomes in Tanzania and Africa at large. In this study we used hospital based registry data from Kilimanjaro Christian Medical Centre in Tanzania to estimate recurrence risk of perinatal death, preterm birth and preeclampsia in subsequent pregnancies. In addition, we estimated the perinatal mortality among the babies of repeated preterm deliveries. Finally, we assessed the effect of recurrent preeclampsia on adverse perinatal outcomes in subsequent pregnancies.
The study showed that there was a 9.1% risk of repeat perinatal mortality. Recurrence contributed 21.2% of all perinatal deaths in subsequent pregnancies. There was 17% risk of repeat premature birth which contributed 15% of the perinatal mortality in the subsequent pregnancies. Preeclampsia repeated in 25% of subsequent pregnancies. Women with a previous history of preeclampsia had increased risks of perinatal death, preterm delivery and delivery of low birth weight infant in their subsequent pregnancy. Our findings suggest that prenatal and neonatal surveillance for women with a previous perinatal death, preterm birth and preeclampsia may help to provide individualized assessment and clinical counseling regarding recurrence. This information could be important for clinicians in Africa for early identification of women at risk during prenatal care and for closer clinical follow-up in their future pregnancies.
Michael was born in Mwanza, Tanzania on 28th November 1972. He started his doctorate at the University of Bergen in August 2010. His supervisors were Professor Rolv T. Lie and Anne K. Dalveit (Department of Global Public Health & Primary Care) and Dr. Rachel Manongi (Kilimanjaro Christian Medical University, Tanzania).