Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015
Background. Adverse pregnancy outcomes, including abortions, miscarriages and stillbirths, are common in developing countries such as Zimbabwe. Objective. To determine the trends and factors associated with adverse pregnancy outcomes. Methods. This article is a secondary data analysis of th...
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South African Medical Association
2024-06-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1399 |
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| author | T Chibura H Twabi K Maluleke A Musekiwa |
| author_facet | T Chibura H Twabi K Maluleke A Musekiwa |
| author_sort | T Chibura |
| collection | DOAJ |
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Background. Adverse pregnancy outcomes, including abortions, miscarriages and stillbirths, are common in developing countries such as Zimbabwe.
Objective. To determine the trends and factors associated with adverse pregnancy outcomes.
Methods. This article is a secondary data analysis of three repeated cross-sectional Zimbabwe Demographic and Health Surveys to assess adverse pregnancy outcomes among women of reproductive age (15 - 49 years old) who fell pregnant during the study period. Bivariate and multivariable logistic regression models were applied to the 2015 dataset to determine factors associated with adverse pregnancy outcomes.
Results. There was an overall increase in reported adverse pregnancy outcomes (stillbirths, miscarriages and abortions) from 2005 to 2015. The percentage of women who experienced adverse pregnancy outcomes among those who fell pregnant in the 5 years preceding each survey rose from 13.4% in 2005 to 13.8% in 2010, followed by a sharp increase to 16.3% in 2015. The multivariable model, belonging to the 35 - 49-year age group, was associated with almost a twofold increased odds of experiencing an adverse pregnancy outcome (adjusted odds ratio (aOR) 2.11, 95% confidence interval (CI) 1.35 - 3.31, p=0.001). Women currently married/in a union (aOR 4.69, 95% CI 2.64 - 8.34, p<0.001) or formerly married/in a union (aOR 3.56, 95% CI 1.89 - 6.69, p=0.001) had higher odds of experiencing an adverse pregnancy outcome. Not belonging to any religion or being a traditionalist or Muslim decreased the odds of experiencing an adverse pregnancy outcome (aOR 0.58, 95% CI 0.42 - 0.80, p=0.001). Women from Harare (aOR 1.56, 95% CI 1.05 - 2.32, p=0.027), Mashonaland West (aOR 1.59, 95% CI 1.08 - 2.36, p=0.027) and Mashonaland Central (aOR 1.76, 95% CI 1.15 - 2.69, p=0.009) provinces had higher odds of experiencing adverse pregnancy outcomes than those from Bulawayo Province. Women who gave birth for the first time at ≥25 years of age (aOR 3.08, 95% CI 2.27 - 4.16, p<0.001) had higher odds of experiencing adverse pregnancy outcomes. Women who delivered 2 - 4 children (aOR 0.75, 95% CI 0.59 - 0.95, p=0.018) or ≥5 children (aOR 0.51, 95% CI 0.36 - 0.72, p<0.001) were less likely to experience adverse pregnancy outcomes.
Conclusion. Trends showed an increase in the proportion of women experiencing adverse pregnancy outcomes in Zimbabwe from 2005 to 2015. Advanced maternal age, marriage, lack of religion and living in Harare, Mashonaland Central or Mashonaland West were associated with adverse pregnancy outcomes. There is a need to reduce these outcomes through integration of social issues into maternal health programmes, as well as ensuring accessibility and availability of comprehensive reproductive health services that target high-risk groups such as women aged 35 - 49 years.
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| format | Article |
| id | doaj-art-68b8e04edf234990a38d420595f7d061 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | South African Medical Association |
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| series | South African Medical Journal |
| spelling | doaj-art-68b8e04edf234990a38d420595f7d0612025-02-10T12:25:54ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-06-011146b10.7196/SAMJ.2024.v114i16b.1399Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015T Chibura0H Twabi 1https://orcid.org/0000-0002-0166-9393K Maluleke2A Musekiwa 3https://orcid.org/0000-0001-5880-3680School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Mathematical Sciences, Faculty of Science, University of Malawi, Zomba, MalawiSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South AfricaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa Background. Adverse pregnancy outcomes, including abortions, miscarriages and stillbirths, are common in developing countries such as Zimbabwe. Objective. To determine the trends and factors associated with adverse pregnancy outcomes. Methods. This article is a secondary data analysis of three repeated cross-sectional Zimbabwe Demographic and Health Surveys to assess adverse pregnancy outcomes among women of reproductive age (15 - 49 years old) who fell pregnant during the study period. Bivariate and multivariable logistic regression models were applied to the 2015 dataset to determine factors associated with adverse pregnancy outcomes. Results. There was an overall increase in reported adverse pregnancy outcomes (stillbirths, miscarriages and abortions) from 2005 to 2015. The percentage of women who experienced adverse pregnancy outcomes among those who fell pregnant in the 5 years preceding each survey rose from 13.4% in 2005 to 13.8% in 2010, followed by a sharp increase to 16.3% in 2015. The multivariable model, belonging to the 35 - 49-year age group, was associated with almost a twofold increased odds of experiencing an adverse pregnancy outcome (adjusted odds ratio (aOR) 2.11, 95% confidence interval (CI) 1.35 - 3.31, p=0.001). Women currently married/in a union (aOR 4.69, 95% CI 2.64 - 8.34, p<0.001) or formerly married/in a union (aOR 3.56, 95% CI 1.89 - 6.69, p=0.001) had higher odds of experiencing an adverse pregnancy outcome. Not belonging to any religion or being a traditionalist or Muslim decreased the odds of experiencing an adverse pregnancy outcome (aOR 0.58, 95% CI 0.42 - 0.80, p=0.001). Women from Harare (aOR 1.56, 95% CI 1.05 - 2.32, p=0.027), Mashonaland West (aOR 1.59, 95% CI 1.08 - 2.36, p=0.027) and Mashonaland Central (aOR 1.76, 95% CI 1.15 - 2.69, p=0.009) provinces had higher odds of experiencing adverse pregnancy outcomes than those from Bulawayo Province. Women who gave birth for the first time at ≥25 years of age (aOR 3.08, 95% CI 2.27 - 4.16, p<0.001) had higher odds of experiencing adverse pregnancy outcomes. Women who delivered 2 - 4 children (aOR 0.75, 95% CI 0.59 - 0.95, p=0.018) or ≥5 children (aOR 0.51, 95% CI 0.36 - 0.72, p<0.001) were less likely to experience adverse pregnancy outcomes. Conclusion. Trends showed an increase in the proportion of women experiencing adverse pregnancy outcomes in Zimbabwe from 2005 to 2015. Advanced maternal age, marriage, lack of religion and living in Harare, Mashonaland Central or Mashonaland West were associated with adverse pregnancy outcomes. There is a need to reduce these outcomes through integration of social issues into maternal health programmes, as well as ensuring accessibility and availability of comprehensive reproductive health services that target high-risk groups such as women aged 35 - 49 years. https://samajournals.co.za/index.php/samj/article/view/1399trendsfactorsadverse pregnancy outcomesabortionsmiscarriagesstillbirths |
| spellingShingle | T Chibura H Twabi K Maluleke A Musekiwa Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 South African Medical Journal trends factors adverse pregnancy outcomes abortions miscarriages stillbirths |
| title | Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 |
| title_full | Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 |
| title_fullStr | Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 |
| title_full_unstemmed | Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 |
| title_short | Trends and factors associated with adverse pregnancy outcomes in Zimbabwe, 2005 - 2015 |
| title_sort | trends and factors associated with adverse pregnancy outcomes in zimbabwe 2005 2015 |
| topic | trends factors adverse pregnancy outcomes abortions miscarriages stillbirths |
| url | https://samajournals.co.za/index.php/samj/article/view/1399 |
| work_keys_str_mv | AT tchibura trendsandfactorsassociatedwithadversepregnancyoutcomesinzimbabwe20052015 AT htwabi trendsandfactorsassociatedwithadversepregnancyoutcomesinzimbabwe20052015 AT kmaluleke trendsandfactorsassociatedwithadversepregnancyoutcomesinzimbabwe20052015 AT amusekiwa trendsandfactorsassociatedwithadversepregnancyoutcomesinzimbabwe20052015 |