Predictors of pregnancy loss in Afghan women presenting to tertiary care hospital-Kabul Afghanistan : case control study
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Background Still birth and miscarriage are most common adverse outcomes of pregnancy. Worldwide each year, four million still births are reported, with 97% occurring in developing countries. Objective To determine factors associated with still births and miscarriages in women presenting to tertiary care hospitals in Kabul Afghanistan Methods Case control study design was carried out to achieve the study objectives. A total of 156 cases (51 still birth and 105 miscarriages) and 373 controls (live births) were selected and interviewed between July to September 2007 at two tertiary Care hospitals of Kabul city Afghanistan. For analysis purpose we developed three models, one for women who had miscarriages with live births, second for women who had still births and live births and third for combination of still birth and miscarriages as a case with live births (Controls). We have done descriptive analysis with univariate and multivariable logistic regression analysis for each model. Results Higher proportion of women who had miscarriage received ANC visits in comparison to those who gave a live birth (Adj OR=0.4, 95%CI: 0.22, 0.63). With each additional pregnancy the odds of miscarriage increased by 1.4 (Adj OR=1.4, 95% Cl: 1.00, 1.95). With one hour increase in exposure to fuel smoke, the odds of miscarriage increased by 1.3 with 95% CI: (1.08, 1.48). Older age was significantly associated with still birth, with each one year increase in age the odds of pregnancy being terminated as stillbirth increased by 1.1 with (95% CI 1, 1.11). With each one hour increase in exposure to daily fuel smoke the odds of still birth increase by 1.2 with (95% CI 1, 1.45) Pregnancy loss (still birth plus miscarriage) as combined outcome was also examined. Odds of not receiving antenatal care visits was higher among women who had pregnancy losses as compared to women who had live births (Adj OR 2, 95% CI: 1.26 3.12). Older age was significantly associated with adverse outcome of pregnancy. Women who had pregnancy loss were two times more at odds of being in age group greater than 35 years as compared to women who had live birth, (Adj OR---2 95% CI: 1.03, 3.86). More over with each hour increase exposure to fuel smoke the odds of pregnancy loss was increased by 1.2 with (95% CI: 1.03, 1.33). Conclusion Pregnancies occurring in late reproductive age, previous history of still births or miscarriages, high number of pregnancy and exposure to fuel smoke are associated with pregnancy loss.
Ataullah, S. (2008). Predictors of pregnancy loss in Afghan women presenting to tertiary care hospital-Kabul Afghanistan : case control study (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.