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Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

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Dellicour, Stephanie, Aol, George, Ouma, Peter, Yan, Nicole, Bigogo, Godfrey, Hamel, Mary J, Burton, Deron C, Oneko, Martina, Breiman, Robert F, Slutsker, Laurence, Feikin, Daniel, Kariuki, Simon, Odhiambo, Frank, Calip, Gregory, Stergachis, Andreas, Laserson, Kayla F, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 and Desai, Meghna (2016) 'Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya'. BMJ Open, Vol 6, Issue 4, e011088.

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Abstract

Objective
Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya.

Design
This was a population-based prospective cohort.

Participants and setting
Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance.

Outcome measure
Miscarriage.

Results
Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed.

Conclusions
This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WQ Obstetrics > Pregnancy Complications > WQ 225 Spontaneous abortion. Fetal death
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjopen-2016-011088
Depositing User: Jessica Jones
Date Deposited: 19 Apr 2016 09:14
Last Modified: 06 Feb 2018 13:12
URI: https://archive.lstmed.ac.uk/id/eprint/5848

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