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
Year: 2019
Type: article
Abstract: 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: 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: 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: 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: NCT01990625 , November 21, 2013.
Source: BMC Pregnancy and Childbirth
Authors: Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. McClure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Ana Garces, Margo S. Harrison, Dennis Wallace, Sarah Saleem, Waseem Mirza, Nancy Krebs, Michael Hambidge, Waldemar Carlo, Elwyn Chomba, Menachem Miodovnik, Marion Koso-Thomas, Edward A. Liechty, Fabian Esamai, Jonathan Swanson, David Swanson, Robert L. Goldenberg, Carl Bose
Institutions: University of North Carolina at Chapel Hill, University of Washington Medical Center, Harborview Medical Center, Ecole de santé publique de Kinshasa, RTI International, Institute of Nutrition of Central America and Panama, University of Colorado Denver, Aga Khan University, University of Alabama at Birmingham, University of Zambia, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Indiana University Indianapolis, Moi University, Seattle Children's Hospital, Columbia University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,136
Awards: The Global Network and Preconception Maternal Nutrition, G319113367, Columbia University/Aga Khan University Global Network Research Unit, G5426933423, NICHD Neonatal Research Network Clinical Center UAB, The University of North Carolina-Kinshasa School of Public Health Research Partnership in the Democratic Republic of Congo; a Model for Improving Women's and Children's Health Through Research, Global Network for Women's and Children's Health Research Data Coordinating Center, Columbia University/Aga Khan University Global Network Research Unit, G975613454
OpenAlex ID: W2964004022