Journal article
Predictors of stillbirth in sub-saharan Africa
Obstetrics and gynecology (New York. 1953), v 110(5), pp 989-997
Nov 2007
PMID: 17978109
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE
To describe the incidence and predictors of stillbirth in a predominantly human immunodeficiency virus (HIV)-infected African cohort.
METHODS
Human Immunodeficiency Virus (HIV) Prevention Trials Network (HPTN) 024 was a randomized controlled trial of empiric antibiotics to reduce chorioamnionitis-related perinatal HIV transmission. A proportion of HIV-uninfected individuals were enrolled to reduce community-based stigma surrounding the trial. For this analysis, only women who gave birth to singleton infants were included.
RESULTS
Of 2,659 women enrolled, 2,434 (92%) mother- child pairs met inclusion criteria. Of these, 2,099 (86%) infants were born to HIV-infected women, and 335 (14%) were born to HIV-uninfected women. The overall stillbirth rate was 32.9 per 1,000 deliveries (95% confidence interval [CI] 26.1-40.7). In univariable analyses, predictors for stillbirth included previous stillbirth (odds ratio [OR] 2.3, 95% CI 1.2-4.3), antenatal hemorrhage (OR 14.4, 95% CI 4.3-47.9), clinical chorioamnionitis (OR 20.9, 95% CI 5.1-86.2), and marked polymorphonuclear infiltration on placental histology (OR 2.9, 95% CI 1.7-5.2). When compared with pregnancies longer than 37 weeks, those at 34-37 weeks (OR 1.7, 95% CI 0.8-3.4) and those at less than 34 weeks (OR 22.8, 95% CI 13.6-38.2) appeared more likely to result in stillborn delivery. Human immunodeficiency virus infection was not associated with a greater risk for stillbirth in either univariable (OR 1.5, 95% CI 0.7-3.0) or multivariable (adjusted OR 1.11, 95% CI 0.38-3.26) analysis. Among HIV-infected women, however, decreasing CD4 cell count was inversely related to stillbirth risk (P=.009).
CONCLUSION
In this large cohort, HIV infection was not associated with increased stillbirth risk. Further work is needed to elucidate the relationship between chorioamnionitis and stillbirth in African populations.
Metrics
Details
- Title
- Predictors of stillbirth in sub-saharan Africa
- Creators
- Benjamin H Chi - University of ZambiaLei Wang - Statistical Center for HIV/AIDS Research and Prevention (United States, Seattle) - SCHARPJennifer S Read - National Institute of Child Health and Human DevelopmentTaha E Taha - Johns Hopkins UniversityMoses Sinkala - Centre for Infectious Disease Research in ZambiaElizabeth R Brown - Statistical Center for HIV/AIDS Research and Prevention (United States, Seattle) - SCHARPMegan Valentine - Family Health International 360Francis Martinson - UNC Project (Malawi, Lilongwe)Robert L Goldenberg - Drexel University
- Publication Details
- Obstetrics and gynecology (New York. 1953), v 110(5), pp 989-997
- Publisher
- Lippincott
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000250360800006
- Scopus ID
- 2-s2.0-35848946348
- Other Identifier
- 991019168296204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Obstetrics & Gynecology