Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study.
Adult
Amniotic Fluid
Cluster Analysis
Developing Countries
/ statistics & numerical data
Female
Global Health
Humans
Incidence
Infant
Infant Mortality
Infant, Newborn
Labor Presentation
Obstetric Labor Complications
/ epidemiology
Polyhydramnios
/ diagnosis
Pregnancy
Prenatal Care
/ methods
Risk Factors
Socioeconomic Factors
Ultrasonography, Prenatal
/ methods
Global health
Low-income country
Polyhydramnios
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
22 Jul 2019
22 Jul 2019
Historique:
received:
07
01
2019
accepted:
15
07
2019
entrez:
24
7
2019
pubmed:
25
7
2019
medline:
14
1
2020
Statut:
epublish
Résumé
In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models with general estimating equations to control for cluster-level effects. The diagnosis of polyhydramnios was confrimed by an U.S. based radiologist in a majority of cases (62%). We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). Polyhydramnios occured in these low and low-middle income countries at a rate similar to high-income contries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death. NCT01990625 , November 21, 2013.
Sections du résumé
BACKGROUND
BACKGROUND
In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
METHODS
METHODS
We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models with general estimating equations to control for cluster-level effects. The diagnosis of polyhydramnios was confrimed by an U.S. based radiologist in a majority of cases (62%).
RESULTS
RESULTS
We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13).
CONCLUSIONS
CONCLUSIONS
Polyhydramnios occured in these low and low-middle income countries at a rate similar to high-income contries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.
TRIAL REGISTRATION
BACKGROUND
NCT01990625 , November 21, 2013.
Identifiants
pubmed: 31331296
doi: 10.1186/s12884-019-2412-6
pii: 10.1186/s12884-019-2412-6
pmc: PMC6647057
doi:
Banques de données
ClinicalTrials.gov
['NCT01990625']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
258Subventions
Organisme : GE Healthcare
ID : n/a
Organisme : NICHD NIH HHS
ID : U24 HD092094
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD076461
Pays : United States
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : UG1 HD078438 06
Organisme : Bill and Melinda Gates Foundation (US)
ID : n/a
Organisme : NICHD NIH HHS
ID : U10 HD078438
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD034216
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD076474
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD076465
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD078438
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD076474
Pays : United States
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