Clinical Phenotypes Associated with Preterm Births at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu County, Kenya
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Date
2019
Authors
Omondi, Juma Edwin
Keraka, Margaret
Wanyoro, Anthony
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Current Aspects
Abstract
Preterm birth is a global health problem. It is the leading cause of child and neonatal mortality
globally including Kenya. Preterm birth is the birth occurring before 37 completed weeks of
gestation. In Kenya, preterm birth is the leading cause of neonatal mortality as it contributes to
35% of deaths among the neonates while Kisumu County is among the county’s leading with
child under-five mortality rate at 133 deaths per 1000 live births. The main objective of this
study was to identify the clinical phenotypes associated with preterm birth in JOOTRH in
Kisumu County. It was a cross sectional study based on women who had a preterm birth alive or
stillbirth at JOORTH in Kisumu County. Purposive sampling technique was used to select 178
respondents who met the inclusion criteria. Interviewer administered questionnaire was used to
collect both qualitative and quantitative data. Data was analyzed by computer software SPSS
version 23; descriptive statistics was used together with inferential statistics (Chi-square and
Fisher’s Exact test) to help in the identification of the statistical significance of any association
between the variables. A p value of < 0.05 was used. Bivariate analysis was utilized to measure
the strength of associations. Data presented by use of frequency tables and narrative description.
Ethical clearance was sought from Kenyatta University Ethics and Review Committee, permit
sought from NACOSTI, consent and assent from the respondents. Results showed that maternal
age (p=0.011) to be statistical significant with preterm births. Clinical phenotypes based on
maternal, fetal and placental conditions; preeclampsia/eclampsia (p=0.016), extrauterine
infections which includes malaria, UTI and HIV (p=0.030), severe maternal conditions that
includes DM, anaemia, cardiac disease, hypertension prior to pregnancy and TB (p=0.001),
multiple gestations (p=0.013), fetal anomaly (0.048), IUGR (p=0.049), antepartum stillbirth
(p=0.046) and APH/early bleeding that include placenta previa and placenta abruption
(p=0.025) were all significantly associated with preterm births. On bivariate analysis between
clinical phenotypes and preterm births, all except multiple gestation (p=0.416) and APH
(p=0.660) remained statistically significant. All clinical phenotypes (maternal, fetal and
placental conditions) were significantly associated with preterm births. All clinical phenotypes
except multiple gestations and APH/early bleeding remained statistically significant after
bivariate analysis. The study recommends the use of Barro’s classifications system of clinical
phenotypes to phenotype all preterm births in JOOTRH. Early identification of maternal, fetal
and placental conditions identified in this study to be associated with preterm births by adopting
Barros’ phenotyping of preterm births as a strategy to help prevent the occurrence of PTBs and
eventually reduce neonatal deaths and under-five mortality.
Description
Keywords
Clinical Phenotypes, Preterm Births, Jaramogi Oginga Odinga Teaching and Referral Hospital
Citation
Juma, E., Keraka, M., & Wanyoro, A. (2019). Clinical Phenotypes Associated With Preterm Births at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu County, Kenya. International Journal of Current Aspects, 3(III), 175-186.