Evolution des donnees maternelles et perinatales recueillies en routine entre 1980 et 1998 a la maternite de reference de Rutshuru en Republique democratique du Congo. II. Deces du nouveau-ne et naissances de faible poids.
Adolescent; Adult; Data Collection; Democratic Republic of the Congo/epidemiology; Female; Humans; Incidence; Infant Mortality/trends; Infant, Low Birth Weight; Infant, Newborn; Pregnancy; Risk Factors
Abstract :
[en] This second paper aims at deriving useful information allowing to improve the strategy applied for maternal health care. MATERIAL AND METHODOLOGY: Between 1980 and 1998, data on 13,042 deliveries were collected. Characteristics, mortality, morbidity of mothers and new-born and obstetrical interventions were recorded. The present work describes the evolution of low birth weight (LBW), new-born deaths, and associated risk factors. The statistical analyses applied included khi2, t-test, and multiple logistic regression. RESULTS: Eighteen percent of new-born weights below 2.5 kg and 7.9% died. The proportion of low birth weights remains globally constant. Low proportions of new-born deaths were observed in 1981, 1982, 1988 and 1998. At admission, 35% of the women presented at least one of the four risks defined by the factors used for reference; this proportion went up from 26.1 to 39.2%. The four reference factors were associated with low birth weight. Baudelocque diameter and age were not associated with new-born death. Education and BMI were associated with an increased risk of new-born death. Marital status was not associated with any of the two outcomes. CONCLUSION: This analysis shows small variation of LBWs and perinatal deaths. It confirms the association between these two outcomes and most of the risk factors studied. The efficacy of the strategies implemented for improving perinatal health is questioned. The authors recommend that they be reassessed.
Disciplines :
General & internal medicine
Author, co-author :
Mugisho, Etienne
Dramaix, Michele
Porignon, Denis ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiques
Musubao, Ernest
Hennart, Philippe
Language :
French
Title :
Evolution des donnees maternelles et perinatales recueillies en routine entre 1980 et 1998 a la maternite de reference de Rutshuru en Republique democratique du Congo. II. Deces du nouveau-ne et naissances de faible poids.
Alternative titles :
[en] Analysis of data routinely collected in the maternity ward of Rutshuru in the Democratic Republic of the Congo between 1980 and 1998. II. New-born deaths and low birth weights
Publication date :
2002
Journal title :
Santé: Cahiers d'Études et de Recherches Francophones
Hemminki E., Starfield B. (1978) Prevention of low birth weight and pre-term birth: Literature review and suggestions for research policy. Milbank Mem Fund Q Health Soc 56:339-361.
McCormick M. (1985) The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 312:82-90.
Kramer M.S. (1987) Determinants of low birth weight: Methodological assessment and metaanalysis. Bull WHO 65:663-737.
Mavalankar D.V., Gray R.H., Trivedi C.R., Parikh V.C. (1994) Risk factors for small for gestational age birth in Ahmedabab, India. J Trop Pediat 40:285-290.
De Brouwere V., Tonglet R., Van Lerberghe W. (1997) La « maternité sans risque » dans les pays en développement: Les leçons de l'histoire. Studies in Health Services Organisation & Policy, 6, Anvers (Belgique): Itg Press; 60 p; .
Barennes H., Moustapha F.T. (1995) La mortalité néonatale sans solution en afrique sahélienne? Bilan et perspectives en milieu urbain à niamey, niger. Cahiers Santé 5:335-340.
Anate M. (1993) Perinatal mortality associated with abnormal presentations at the university of Ilorin Teaching hospital, Ilorin-Nigeria: A prospective study. West Afr J Med 12:206-210.
Fawcus S.R., Crowther C.A., Van Baelen P., Marumahoko J. (1992) Booked and unbooked mothers delivering at Harare maternity hospital, Zimbabwe: A comparison of maternal characteristics and fetal outcomes. Cent Afr J Med 38:402-408.
Porignon D., Mugisho E., Elongo T., Katulanya D., Hennart P., Van Lerberghe W. (1998) How robust are district health systems? Coping with crisis and disasters in Rutshuru, democratic Republic of Congo. Trop Med Internat Health 3:559-565.
Meuris S., Piko B., Eerens P., Vanbellinghen A.M., Dramaix M., Hennart P. (1993) Gestational malaria: Assessment of its consequences on fetal growth. Ame Jour Trop Med Hyg 48:603-609.
Mugisho E., Dramaix M., Porignon D. (2000) Efficacité de la chimio-prophylaxie précoce ou tardive par la chloroquine donnée pendant la grossesse en milieu d'endémie malarienne au kivu, RDC. Rev Epidem et Sante Publ 48.
Tonglet R., Katulanya I., Chiabrera F. (1991) Pattern of attained growth in 0 to 5 year-old children from Kivu (Zaire). Ecology of Food and Nutrition 26:215.
Porignon D., Katulanya I., Elongo L., Ntalemwa N., Tonglet R., Dramaix M., Hennart P. (2000) The unseen face of humanitarian crisis in Eastern democratic Republic of Congo: Was nutritional relief properly targeted?. J Epidemiol Com Health 54:6-9.
(1980) The incidence of low birth weight: A critical review of available information. World Health Statist 33:197.
(1984) The incidence of low birth weight: An update. Weekly Epidemiol 59:205.
De Muylder X., Thiery M. (1990) The cesarean delivery rate can be safely reduced in a developing country. Obst Gynecol 75:360-364.
Liljestrand J., Bergström S., Ndobe C., Da Silva B., Hernborg A. (1992) Obstetrical risk factors and pregnancy outcome in rural Mozambique. Gynecol Obstet Invest 34:217-221.
Rooney C. Soins prénatals et santé maternelle: étude d'efficacité, Genève: OMS; 1992.
(1984) Antenatal screening for fetopelvic dystocias. A cost-effectiveness approach to the choice of simple indicators for use by auxiliary personnel. J Trop Med Hygi 87:173-183.
(1995) The prevention of maternal mortality network. Situation analysis of emergency obstetric care: Examples from eleven operations research project in West Africa. Soc Sci Med 40:657-667.
(1992) The prevention of maternal mortality network. Barriers to treatment of obstetric emergencies in rural communities of West Africa. Studies in Family Planning 23:279-291.